/AATERIA/talCA 

FOR^  NURSES 


By  Lavinia  L.  Dock 


A  TEXT-BOOK  OF  MATERIA  MEDIC  A 
FOR  NURSES.  Fifth  Edition,  Revised 
and  Enlarged.  Cr.  8vo.  Net,  $i  .50. 
Postage  extra. 

HYGIENE  AND  MORALITY.    Net,  $1.25. 

A  HISTORY  OF  NURSING.  In  collabora- 
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tries of  the  Science  of  Trained  Nurs- 
ing with  Special  Reference  to  the 
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TEXT-BOOK 

OF 


MATERIA    MEDICA 

FOR    NURSES 


COMPILED  BY 

LAVINIA  L.  DOCK 

GRADUATE   OF    BELLEVUB    TRAINING   SCHOOL   FOR   NURSES 


SIXTH  EDITION,  REVISED  AND  ENLARGED 


REVISED  IN  ACCORDANCE  WITH  THE  NINTH  DECENNIAL 
REVISION  OF  THE  U.  S.  PHARMACOPOEIA 


G.  P.  PUTNAM'S  SONS 

NEW  YORK  &  LONDON 

Gbe  Imfc&etbocftet  press 

1916 


^ 

^ 

*»$ 


COPYRIGHT,  1890 

BY 
LAVINIA   L.  DOCK 


COPYRIGHT,  1897 

BY 
G.  P.  PUTNAM'S  SONS 


COPYRIGHT,  1905 

BY 
G.  P.  PUTNAM'S  SONS 


COPYRIGHT,  1915 

BY 
G.  P.  PUTNAM'S   SONS 

COPYRIGHT,  1916 

BY 
G.  P.  PUTNAM'S  SONS 


Authority  to  ^s«.  fty>  comt&sut  thj  Pharmacopoeia  of  the  United  States  o>. 
America,  Ninth  Decennial  Revision,  »'r  T,hio  volume,  has  been  granted  by 
the  Board  of  Trustees  of  the  United  States  Pharmacopcei  .1  Convention, 
which  Board  of  Trustees  is  in  no  way  responsible  for  the  accuracy  of  any 
translations  of  the  official  weights  and  measures  or  for  any  statements  as 
to  strength  of  official  preparations. 


Ubc  fmicfecrbocfcer  press,  f*ew  Iflorfc 


PREFACE  TO  THE  SIXTH  EDITION. 

THE  special  feature  of  this  revision  is  a  chapter  on 
Solutions,  prepared  by  Miss  Ethel  Johns  of  the  Johns 
Hopkins  Hospital  Training  School  for  Nurses. 

The  dosage  has  been  radically  altered  to  follow  the 
averages  as  set  by  the  Ninth  Decennial  Revision  of  the 
United  States  Pharmacopoeia. 


358060 


PREFACE  TO  THE  FOURTH  EDITION. 

THE  latest  revision  of  the  Materia  Medica  has  been 
entrusted  to  Miss  Bean  of  the  Johns  Hopkins  Hospital 
Training  School  for  Nurses. 

As  in  former  revisions,  synthetic  remedies  which  have 
borne  the  test  of  practical  experiment  have  been  in- 
cluded, no  attempt  being  made  to  present  a  full  list  of 
these  innumerable  drugs.  As  in  former  revisions  also, 
the  sources  of  information  have  been  personal  rather 
than  from  books;  not  taken  from  other  works  on 
Materia  Medica  but  collected  in  the  pharmacy,  the 
class-room,  and  the  clinic.  Thus  is  preserved  the 
practical  character  which  is  essential  in  the  teaching 
of  the  nurse. 

Whenever  necessary  to  meet  the  changes  in  the 
last— Ninth  Decennial— edition  of  the  United  States 
Pharmacopoeia  the  text  of  the  book  has  been  changed. 
A  generous  list  of  new  drugs  or  new  preparations  of 
drugs  will  be  found  either  in  their  proper  classification 
or  towards  the  end  of  the  book,  and  much  recent  ma- 
terial on  alcohol,  salts,  and  other  substances  has  been 
incorporated.  Changes  in  dosage  have  been  made,  the 
therapeutic  classification  recast  and  improved,  and  new 
tables  added. 

There  is  given  information  on  serum-  and  organo- 
therapy, notes  on  the  hypodermic  administration  of 
drugs,  emetics,  and  the  treatment  of  poisoning,  a  list 
of  the  better-known  mineral  waters,  and  an  exhaustive 
index  which  will  greatly  facilitate  the  book's  use  by 
the  student. 

Especial  thanks  for  practical  help  in  the  past  are 
due  to  Mr.  J.  I,.  Walz,  the  late  pharmacist  of  the  Johns 
Hopkins  Hospital. 


Vi  PREFACE. 

The  author  feels  impelled  by  the  experience  of  many 
years  to  remind  nurses  of  the  subtle  dangers  of  many 
potent  remedies  with  which  they  are  entrusted,  and  to 
urge  upon  them  most  gravely  never  to  lose  sight  of  the 
dreadful  possibility  of  falling  under  the  influence  of  cer- 
tain drug  habits  unfortunately  but  too  easily  acquired 
in  accession  to  the  relief  offered  by  drugs  in  moments 
of  fatigue  or  of  nerve  exhaustion.  Not  to  prop  her  fail- 
ing strength  by  stimulating  drugs  is  imperative  for  the 
nurse.  It  is  never  necessary  to  tell  a  good  nurse  not 
to  prescribe  for  others — she  scorns  an  act  which  is  not 
only  unprofessional,  but  in  the  worst  possible  taste. 

The  newest  teaching  inclines  steadily  to  less  and  less 
drug  giving.  Dr.  Osier  says  that  the  patient  who 
takes  a  medicine  must  recover  twice — once  from  the  dis- 
ease and  once  from  the  medicine.  The  newer  teaching 
of  nurses,  too,  must  remove  the  cult  of  the  drug  some- 
what farther  into  the  background  and  make  more 
prominent  the  glorious  principles  of  health  preservation 
and  reverence  for  Nature  and  her  laws. 


PREFACE. 

study  of  materia  medica  is  made,  to  some 
extent,  a  part  of  the  course  in  all  our  training  schools 
for  nurses;  but,  so  far,  no  text-book  has  been  prepared 
along  the  special  lines  followed  in  class  recitations. 

Those  special  lines  are  well  defined,  and  are  limited. 
They  begin  and  end  with  medicines,  and  do  not  run 
into  therapeutics.  The  application  of  medicine  to  dis- 
ease is  no  part  of  a  nurse's  study,  and  there  are  there- 
fore some  inconveniences  met  with  in  using — as 
text-books — works  on  materia  medica  which  are  writ- 
ten solely  for  the  use  of  the  medical  profession. 

Large  works,  containing  all  the  points  which  a  nurse 
needs  to  know,  contain  also  an  immense  amount  of 
matter  with  which  she  has  nothing  to  do,  and  are  very 
expensive  ;  while  those  which  are  more  concise  usually 
presuppose  a  large  amount  of  information,  and  are, 
indeed,  not  intended  to  be  used  at  the  beginning  of  a 
course  of  study,  but  rather  at  the  end. 

It  is  in  the  hope  of  filling  this  middle  place  that  this 
text-book  has  been  compiled,  and  the  attempt  made  to 
collect  from  all  available  sources  the  scattered  points 
which  concern  a  nurse,  and  to  give  them  simply  and 
directly.  The  outlines  followed  are  those  of  the  classes 
in  materia  medica  as  taught  in  most  of  our  training 
schools  for  nurses,  and  include  something  of  the  source 
and  composition  of  drugs  ;  their  physiological  actions  ; 
signs  indicating  their  favorable  or  unfavorable  results ; 
the  symptoms  of  poisons,  with  their  antidotes ;  and 
practical  points  on  administration. 

For  material  I  am  indebted  to  the  following  works: 
"Materia  Medica  and  Therapeutics,"  by  Dr.  H.  C. 

vii 


viii  PREFACE. 

Wood;  "Quiz  Compend  of  Materia  Medica,"  by  Dr.  S. 
O.  Potter;  "Materia  Medica  and  Therapeutics,"  by 
Dr.  R.  Bartholow  ;  "  Lectures  on  Materia  Medica  and 
Therapeutics,"  by  Dr.  Thomson,  edited  by  Dr.  Le 
Fevre;  "  Manual  of  Pharmacology,  Therapeutics,  and 
Materia  Medica,"  by  Dr.  T.  Lauder  Brunton;  "Materia 
Medica  and  Therapeutics,"  by  Dr.  J.  Mitchell  Bruce; 
and  Dr.  Farquharson's  "  Guide  to  Therapeutics  and 
Materia  Medica,"  edited  by  Dr.  Woodbury. 

I  gratefully  acknowledge  the  kind  permission  ac- 
corded by  the  authors  and  publishers  of  the  first  five 
works  to  make  extracts  from  them.  For  the  use  of  the 
last  two  I  am  indebted  to  the  courtesy  of  Messrs.  Lea 
Brothers.  Sincere  thanks  are  due  also  to  Dr.  Charles 
Rice  for  much  kindness  in  giving  assistance  and  in- 
formation, and  in  contributing  a  table  of  comparison 
between  minims  and  drops;  and  to  Dr.  George  Dock 
for  revision  and  corrections  and  for  many  practical  sug- 
gestions. The  classification  follows  that  used  by  Dr. 
Brunton  and  Dr.  Bruce.  The  doses  follow  the  averages 
set  by  the  U.  S.  P.,  and  not,  as  before,  taken  mainly 
from  Dr.  Wood's  "  Materia  Medica  and  Therapeutics." 


THE  NEW  PHARMACOPOEIA. 

THE  Ninth  Decennial  Revision  of  the  Pharmacopoeia 
of  the  U.  S.  A.  is  in  many  respects  the  most  interesting 
as  well  as  the  most  important  yet  issued,  and  the  ex- 
planatory matter  contained  in  its  Preface  and  Introduc- 
tory Notices  gives  so  much  that  is  valuable,  not  only  to 
professional  persons  but  also  to  the  intelligent  laity, 
that  it  seems  well  to  summarize  briefly  here  such  points 
as  are  of  general, — not  too  technical — information. 

The  U.  S.  P.  IX,  as  it  is  briefly  and  oflicially  called, 
possesses  far  greater  actual  authority  than  any  former 
revision,  because  the  National  Food  and  Drugs  Act, 
passed  by  Congress  in  1906  and  followed  by  legislation 
along  the  same  lines  by  the  various  States,  makes  the 
United  States  Pharmacopoeia  and  the  National  Formu- 
lary the  standards  for  drugs  intended  to  be  used  for  the 
cure,  mitigation,  or  prevention  of  disease  of  either  man 
or  animals. 

This  has  made  it  possible  to  obtain  manufacturing 
details  heretofore  withheld  from  publication,  to  set  an 
exact  standard  of  precision,  and  to  use  the  imperative 
mood,  instead  of  the  conditional  "if"  employed  in 
earlier  revisions. 

At  the  same  time,  while  scientifically  exact,  the 
Pharmacopoeia  seems  plainer  and  simpler  than  ever 
before,  as  a  number  of  compound  preparations  have 
been  deleted  and  given  over  to  the  National  Formulary, 
while  the  Pharmacopoeia  provides  standards  for  vegeta- 
ble drugs,  chemical  substances,  and  such  pharmaceuti- 
cal preparations  as  are  simple  in  character  and  most 
largely  used. 

A  few  compound  preparations,  much  used,  have  been 
is 


X  THE  NEW  PHARMACOPCEIA. 

retained,  and  an  increased  number  of  standardized 
serums  and  animal  products  admitted. 

A  number  of  synthetic  remedies  have  been  added  to 
the  list,  and  had  it  not  been  for  the  European  War 
possibly  more  might  have  been  included  with  permission 
of  the  manufacturers. 

The  word  "mil"  is  now  used  instead  of  the  term 
"cubic  centimeter."  The  U.  S.  Bureau  of  Standards 
declared  that  the  latter  term  was  a  misnomer,  there 
being  a  slight  difference  between  the  thousandth  part 
of  a  liter  and  the  cubic  centimeter. 

The  British  Pharmacopeia  has  also  adopted  the  word 
mil,  which  is  "short "  for  milliliter,  and  this  brings  uni- 
formity into  the  two  pharmacopoeias  in  the  English 
language. 

A  new  detail  in  the  interest  of  uniform  exactitude  is 
the  adoption  of  official  abbreviations  of  the  names  of 
drugs.  As  these  are  intended  for  prescription  writing 
and  drug-room  use,  it  has  not  been  thought  necessary 
to  include  them  in  this  volume. 

Synonyms  are  also  recognized  and  follow  the  titles 
printed  in  a  smaller  type.  In  some  cases,  even  when 
these  synonyms  are  of  a  purely  popular  character,  if 
widely  used  they  are  repeated  in  the  U.  S.  P. 
IX. 

The  doses  given  are  averages  only.  The  Metric  Sys- 
tem of  Weights  and  Measures  is  of  course  the  only  one 
recognized  in  the  formulas  of  the  Pharmacopoeia,  but 
because  of  the  general  use  by  physicians  of  the  time- 
honored  Apothecaries  Weights  and  Measures,  these 
symbols  are  also  given  in  the  dosage. 

For  writing  formulas  in  the  latter  system,  Roman 
numerals  are  employed  to  follow,  never  to  precede, 
the  symbol  or  abbreviation,  thus:  %  ii,,  gr.  xv. 

In  the  case  of  metric  abbreviations,  the  numerals 
precede  the  abbreviation,  and  are  always  written  in 
Arabic  characters,  thus:  5  Gms.,  2  mils. 

Because  of  the  possibility  of  mistaking  the  abbrevia- 
tion for  gramme  with  that  for  grain,  the  former  is  always 
to  have  a  capital  (Gm.)  while  the  latter  has  always  a 


THE  NEW  PHARMACOPCEIA.  xi 

small  letter  (gr).  These  points  are  important  for  nurses 
to  note. 

It  is  important  to  remember  that,  because  of  the 
absolute  exactitude  of  the  metric  dosage,  it  is  practi- 
cally impossible  to  give  true  equivalents  in  the  apothe- 
caries system,  or  to  translate  one  correctly  into  the 
other.  It  is  only  possible  to  give  an  average  dose  in 
each  system,  and  the  figures  for  doses  are  not  to  be  re- 
garded as  interchangeable  nor  as  equivalents. 

The  International  Conference  for  the  Unification  of 
Formulas  for  Potent  Remedies  has  recommended  that 
certain  standards  for  potent  medicines  be  recognized  by 
all  the  nations  of  the  world.  The  Committee  on  Re- 
vision of  the  Ninth  U.  S.  P.  recommends  that  the  next 
Committee  adopt  these  standards.  This  would  mean  a 
long  step  towards  unification  of  drug  standards  through- 
out the  world. 

An  unexpected  feature  of  the  pharmacopoeia  is  the 
absence  of  brandy,  whiskey,  and  wines.  This  is  be- 
cause of  the  inexact  quantity  of  alcohol  which  they 
contain  and  the  consequent  impossibility  of  maintaining 
a  fixed  standard  of  purity. 

Alcohol,  being  capable  of  exact  chemical  expression, 
is  used  officially  in  the  preparation  of  drugs. 

For  medicinal  use  when  desired  the  physician  can 
order  such  wines,  or  brandy  or  whiskey,  according  to 
the  standards  of  the  U.  S.  P.  VIII. 


CONTENTS 

PAGE 

TO  THE  SIXTH  EDITION       .       „       .        .       .  iii 

PREFACE  TO  THE  FOURTH  EDITION    .       .        ,       .       .  v 

PREFACE        .        .       •        .*.«....  vii 

THE  NEW  PHARMACOPCEIA.         .       :•       •       .       •       .  ix 

INTRODUCTION      .       .       «    ,  •       •    '  "•       •       •  .     •  I 

NOTES  ON  SOLUTIONS _  ....  12 

THE  METRIC  SYSTEM 21 

CLASSIFICATION  OF  REMEDIES 26 

PART  I.— THE  INORGANIC  MATERIA  MEDICA: 

The  Alkalies  and  Alkaline  Earths  40 

The  Metals     .       .        .       •  <•••••        .       *       .  61 

The  Non-Metallic  Elements 94 

The  Inorganic  Acids •        .109 

The  Organic  Acids 114 

The  Carbon  Compounds        .       .       .       .       .        .  123 

PART  II.— THE  ORGANIC  MATERIA  MEDICA  : 

The  Vegetable  Kingdom       .        .        •       . '      J       .  165 

The  Animal  Kingdom  .        .        .        .       •    •    •        .  262 

POISONS  AND  THEIR  TREATMENT 270 

EMETICS      .       .       .       .       •       •       •       •      •       •  275 

HYPODERMICS 278 

SERUM  THERAPY ••  281 

ELECTRO-THERAPEUTICS  AND  RADIOLOGY        . ,      .       .  288 
MINERAL  WATERS       .       ...       .       .       .       .293 

UNCLASSIFIED  DRUGS  (ALPHABETICALLY  ARRANGED)     .  298 
INDEX    ...       .       .       .    *  ,       .       .       .       .3-3 

xiii 


INTRODUCTION. 


broad  meaning  of  medicine  (Medidna)  is  "  the 
science  and  art  of  healing  and  curing  the  sick  '  '  (Gould); 
but  aside  from  this  meaning  the  word  is  used  in  a  re- 
stricted sense,  to  signify  a  drug  used  for  the  cure  or 
relief  of  disease.  The  word  drug  means  *  '  a  substance, 
simple  or  compound,  natural  or  prepared,  single  or 
mixed  with  other  substances,  used  as  a  medicine" 
(Gould);  and  "  Materia  Medica  "  covers  the  entire  list 
of  such  substances,  with  their  whole  history. 

On  beginning  the  study  of  Materia  Medica  a  general 
knowledge  should  be  acquired  of  the  classification  of 
drugs  considered  from  three  standpoints: 
I.  Their  source  of  derivation. 
II.  Their  physiological  actions. 

III.  Their  ultimate  forms  and  appearance  as  prepared 
in  the  pharmacy  by  definite,  standard  formulae,  for 
administration. 

I.  Both  the  organic  and  the  inorganic  worlds  furnish 
material  useful  for  medicine,  and  in  the  former  both 
the  animal  and  the  vegetable  kingdoms  are  represented. 
The  class  of  inorganic  drugs  is  large,  and  comprises 
alkalies,  alkaline  earths,  acids,  metals,  and  non-metals. 
Among  them  all  are  many  familiar  elements,  as  lead, 
iron,  etc. 

The  animal  kingdom  furnishes  but  a  small  quota. 
The  drugs  of  vegetable  origin  are  by  far  the  most 
numerous,  and  are  obtained  from  green  and  flowering 
plants,  both  fresh  and  dry,  fungi,  and  lichens.  The 
whole  plant  may  be  represented,  or  a  part  only,  as  the 
flowers,  seeds,  fruit,  stems,  or  roots.  The  constituents 
of  vegetable  drugs  are  many  and  varied  in  character, 
some  of  them  being  of  great  potency.  They  are  ex- 


2  MATERIA  MEDICA  FOR  NURSES. 

tracted  from  the  plant  and  isolated  in  a  pure  form  by 
elaborate  chemical  processes,  and  by  means  of  especially 
constructed  appliances. 

The  principal  ones  are  as  follows:  aromatic,  odor- 
ous, and  bitter  principles,  albuminous  bodies,  starches 
and  sugars,  glucosides,  oils,  gums,  resins  and  oleo- 
re'sins,  and  alkaloids.  Gums  are  exudations  from  the 
stems  of  plants.  Resins  are  solid,  brittle,  non-volatile 
substances,  insoluble  in  water;  and  oleo-resins  may  be 
broken  up  into  resins  and  volatile  oils. 

The  alkaloids  are  the  most  important,  forming  as 
they  do  a  class  of  poisons  of  marked  characteristics  and 
great  intensity.  They  are  nitrogenous  compounds, 
many  of  them  of  deadly  power,  and  are  spoken  of  as 
the  "  active  principles  "  of  those  drugs  in  which  they 
are  found,  and  to  which  they  lend  their  own  distinctive 
properties.  The  name  alkaloid  is  given  to  them  from 
their  similarity  in  many  ways  to  alkalies. 

The  other  constituents  of  vegetable  drugs  are  rela- 
tively unimportant. 

II.  In  considering  drugs  in  reference  to  the  second 
division,  we  find  them  grouped  according  to  the  effect 
they  have  on  the  human  organism  in  disease.  This 
mode  of  classification  must  be  grasped  broadly,  not  by 
rule.  It  is  impossible  to  assign  fixed  and  definite 
places  to  all  medicines  from  this  standpoint,  or  to  draw 
sharp  lines  of  division.  Remembering  the  complex 
nature  of  plants,  and  that  one  drug  may  contain  more 
than  one  active  alkaloid,  and  a  number  of  the  less  im- 
portant substances  just  named,  it  is  evident  that  one 
medicine  may  have  several  actions;  and  practically  it 
is  found  that  their  effects  are  as  scales  of  varying  grada- 
tion, and  run  insensibly  into  one  another.  The  same 
drug  that  in  small  doses  acts  as  a  beneficent  agent  may 
in  large  ones  be  an  overwhelming  poison;  one  given 
to  quiet  the  nervous  system  may  also  constipate; 
another  given  for  purgation  may  seriously  reduce  the 
strength  of  the  heart;  another  given  to  strengthen  the 
heart  may  also  increase  the  flow  of  urine,  so  that  classi- 
fication may  well  be  sometimes  a  little  puzzling. 


INTRODUCTION.  3 

It  will  dispel  bewilderment  to  remember  that  the 
most  important  and  prominent  characteristic  of  a  drug 
is  usually  taken  as  its  representative  quality,  the  others 
being  for  the  time  ignored. 

Individual  peculiarities  have  much  to  do  in  modify- 
ing the  physiological  actions  of  drugs.  The  more 
highly  strung  nervous  organizations  respond  more 
quickly,  as  a  rule,  to  the  actions  of  drugs  than  do  those 
of  coarser  fibre,  and  more  quickly  show  evidence  of 
over-dosing  and  mild  poisoning.  Among  these  tem- 
peraments are  found  many  examples  of  what  is  called 
t:  idiosyncrasy  " — that  is,  an  increased  susceptibility  to 
the  effects  of  a  drug  which  entirely  forbids  its  use,  and 
for  which  no  reason  can  be  discovered. 

Custom  makes  a  decided  difference,  and  the  action 
of  a  medicine  is  more  energetic  with  one  unused  to  it. 
With  frequent  repetition  comes  "  toleration,"  when 
the  system  accommodates  itself  to  the  drug,  and  larger 
doses  can  be  taken  with  relatively  less  effect.  Beyond 
this  point  comes  "  habit,"  when  the  system  not  only 
tolerates  but  craves  the  drug  in  ever  increasing  quanti- 
ties, and  with  the  result  of  a  progressive  degradation 
of  the  will  power,  as  is  most  strikingly  shown  in  the 
ascendency  of  alcohol  and  opium  over  the  individual. 

"Accumulation  "  and  "  cumulative  action  "  of  drugs 
are  expressions  often  met  and  are  self-explanatory  up 
to  a  certain  point.  While  it  might  be  difficult  to  ex- 
plain the  exact  processes  in  the  body  tissues  by  which 
drugs  are  stored  up  or  accumulate  in  them,  it  is,  fortu- 
nately, sufficient  for  practical  purposes  to  know  that  a 
number  of  drugs  do  become  apparently  fixed  in  the 
tissues,  and  that  many  others  accumulate  by  being 
given  more  rapidly  than  they  can  be  excreted. 

Age  is  an  important  factor  to  consider.  Strong 
drugs,  and  especially  those  that  act  on  the  brain,  are 
given  with  much  care  to  children  and  to  the  aged. 
The  condition  of  the  stomach  is  another  point  to  con- 
sider. Medicines  act  more  rapidly  on  an  empty 
stomach,  and  any  irritating  properties  they  may  have 
are  then  more  marked.  Given  with  or  soon  after  food 


4  MATERIA   MEDIC  A  FOR  NURSES. 

the  action  is  more  gentle  and  slow.  The  kinds  of  food 
taken  are  to  be  thought  of,  and  any  which  might 
neutralize  the  medicine  should  be  put  off  for  a  safe 
interval.  In  giving  medicines  to  produce  sleep,  all 
conditions  favorable  to  sleep  must  first  be  secured. 
The  good  effect  of  many  a  hypnotic  is  lost  through  the 
failure  to  provide  darkness,  warmth,  arid -quiet  before 
giving  it. 

In  general  the  effects  of  medicines  are  classed  as 
primary  and  secondary,  immediate  or  remote.  By  the 
primary  or  immediate  action  is  meant  the  first  definite 
result  of  the  drug,  and  subsequent  changes  which  are 
brought  about  by  this  first  result  are  termed  the  second- 
ary or  remote  effects,  viz.,  if  a  diuretic  is  administered 
to  a  dropsical  patient  a  copious  flow  of  urine  soon 
occurs  as  the  primary  effect.  As  a  result  of  increased 
urination  fluid  is  largely  abstracted  from  the  body 
tissues,  and  the  consequent  diminution  of  the  dropsy 
is  the  secondary  effect.  The  classes  of  medicine  ac- 
cording to  their  physiological  actions  are  arranged 
as  follows : 

Absorbents. — Those  which  produce  absorption  and 
exudation  of  diseased  tissue  (Gould). 

Alteratives. — A  rather  vague  term,  not  universally 
approved,  applied  to  certain  drugs  which  have  an  un- 
explainable  power  over  the  nutritive  processes. 

Anaesthetics. — Those  which  produce  a  state  of  in- 
sensibility to  pain.  They  may  be  (a)  general,  as  ether; 
or  (ff)  local,  as  cocaine. 

Analeptics. — Restorative  medicines,  or  food. 

Anodynes,  Analgesics. — Those  which  give  relief 
from  pain. 

Antacids. — Those  which  counteract  acidity. 

Anthelmin tics. —Those  used  to  expel  (vermifuge) 
or  kill  (vermicide)  intestinal  parasites. 

Antiarthritics.— Medicines  which  relieve  gout. 

Antihydropics. — Those  which  relieve  dropsical  con- 
ditions. 

Antilithics.— Those  which  dissolve  calculi. 

Antiperiodics. — Those  which  break  up  the  rhythm!- 


INTRODUCTION.  5 

cal  character  of  some  manifestations  of  disease,  as  chills 
in  ague. 

Antipyretics, — Those  which  reduce  fever. 

Antiseptics. — Medicines  which  prevent  putrefac- 
tion. 

Antispasmodics. — Those  which  relieve  convulsions 
and  spasmodic  pains  (Gould). 

Antizymotics. — Those  which  have  power  to  kill 
disease  germs. 

Aromatics. — Medicines  characterized  by  a  spiciness 
of  odor  and  taste,  stimulant  to  the  gastro-intestinal 
mucous  membrane. 

Astringents. — Those  which  tend  to  contract  the 
tissues,  thus  checking  secretions. 

Bitters — aromatic.— Those  which  unite  the  proper- 
ties of  the  aromatics  and  the  bitters. 

Bitters — simple. — Medicines  which  have  a  bitter 
taste  and  power  of  stimulating  the  gastro-intestinal 
tract  without  affecting  the  general  system. 

Calefacients. — Those  used  to  produce  a  sense  of 
warmth. 

Cardiac  Depressants.— Those  which  weaken  the 
heart's  action. 

Cardiac  Stimulants. — Those  which  strengthen  the 
heart's  action. 

Carminatives  are  slightly  stimulant,  and  expel  gas 
from  the  stomach  and  intestines. 

Cathartics,  Purgatives. — Those  which  produce 
evacuation  of  the  bowels.  They  are  subdivided  as 
follows :  laxatives,  or  aperients,  those  of  gentle  action, 
among  which  are  fruits  and  some  vegetables;  drastic 
cathartics,  those  of  severe  action  causing  griping ; 
hydragogue  cathartics,  those  which  remove  water 
freely  from  the  intestines.  Some  of  the  drastics  belong 
to  this  class,  and  all  salines.  Saline  cathartics  produce 
a  copious  flow  of  serum  from  the  intestinal  walls  into 
the  canal.  The  blood  serum  being  of  one  degree  of 
alkalinity  and  the  salts  a  much  stronger  solution,  an 
active  exchange  takes  place  until  the  two  are  equalized. 
It  was  formerly  taught  that  salts  should  be  given  in  a 


6  MATERIA   MEDICA   FOR  NURSES. 

large  quantity  of  water,  but  Dr.  Hay  teaches  giving 
them  in  saturated  solution,  and  states  that  it  is  not  the 
amount  of  water  in  the  canal,  but  in  the  tissues  that  is 
of  importance,  and  that  purgation  may  be  prevented 
by  withholding  water  from  the  diet  for  a  day  or  two. 

Caustics. — Drugs  which  have  the  power  of  destroy 
ing  living  tissue. 

Cholagogues. — Those  which  cause  a  flow  of  bile. 

Convulsants. — Those  which  cause  convulsions. 

Correctives. — Medicines  used  to  correct  or  render 
more  pleasant  the  action  of  other  remedies,  especially 
purgatives. 

Demulcents. — Mucilaginous  principles  which  are 
used  in  solution  to  soothe  and  protect  irritated  mucous 
membranes  or  other  tissues. 

Deodorants.— Substances  which  destroy  or  hide 
foul  odors. 

Depilatories. — Those  used  to  remove  hair. 

Depresso-Motors.— Those  which  lessen  the  activ- 
ity of  the  spinal  cord  and  motor  centres  (Gould). 

Depurants. — Medicines  which  stimulate  excretions 
and  so  purify  the  system. 

Detergents. — Those  which  cleanse  wounds,  ulcers, 
etc. 

Diaphoretics. — Those  which  increase  the  action  of 
the  skin  and  produce  perspiration. 

Diluents. — Those  which  dilute  the  secretions  of 
organs. 

Disinfectants. — Those  which  have  the  power  of 
destroying  disease  germs  or  noxious  properties  of 
organic  matter. 

Diuretics. — Those  which  increase  the  flow  of  urine. 

Ecbolics. — Those  which  produce  abortion. 

Emetics. — Those  which  produce  emesis  or  vomit- 
ing: (a)  local  emetics,  those  that  act  directly  on  the 
nerves  of  the  mucous  membrane  of  the  stomach,  and 
(b)  systemic  emetics,  those  that  act  on  the  vomiting 
centres  in  the  medulla. 

Emmenagogues. —Those  which  stimulate  the  men- 
strual  flow. 


INTRODUCTION.  7 

Emollients. — Substances  used  to  soften  and  protect 
tissue. 

Epispastics,  Escharotics.— Those  which  produce 
blisters  and  sloughing. 

Errhines. — Medicines  which  increase  the  nasal 
secretion. 

Evacuants. — A  term  applied  to  purgatives. 

Excito-Motors. — Those  which  increase  the  activity 
of  the  spinal  cord  and  motor  centres  (Gould). 

Expectorants. — Those  which  increase  bronchial 
secretions. 

Febrifuges. — Medicines  which  dissipate  fever. 

Galactagogues.— Those  which  increase  the  secre- 
tion of  milk. 

Haemostatics. — Such  as  arrest  haemorrhage. 

Hypnotics. — Those  which  produce  sleep,  but  have 
no  power  over  pain.  All  anodynes  are  also  hypnotics, 
but  all  hypnotics  are  not  anodynes. 

Mydriatics. — Drugs  which  cause  mydriasis  or  dila- 
tation of  the  pupil. 

Myotics. — Those  which  cause  myosis  or  contraction 
of  the  pupU. 

Narcotics. — Those  which  have  intensified  anodyne 
and  hypnotic  power,  producing  a  condition  of  stupor. 

Neurotics. — Those  which  act  on  the  nervous  system. 

Nutriants. — Drugs  which  modify  nutritive  pro- 
cesses. 

Nutrients. — Substances  which  nourish. 

Oxytocics. —  Medicines  which  stimulate  uterine 
contractions. 

Prophylactics. — Medicines  which  prevent  the  tak- 
ing or  development  of  a  disease. 

Refrigerants. — Those  which  lessen  the  body  tem- 
perature. 

Revulsants. — Those  which,  by  causing  irritation, 
serve  to  draw  the  blood  from  a  distant  diseased  part. 
Counter-irritants. 

Rubefacients.— Those  which  redden  the  skin  by 
distending  the  capillaries.  Rubefacients,  epispastics, 
and  escharotics  must  be  classified  loosely,  as  many 


8  MATERIA   MEDICA  FOR  NURSES. 

drugs  have  all  three  actions,  according  to  the  length 
of  time  and  severity  of  application.  Nitrate  of  silver  is 
an  escharotic  which  does  not  belong  to  the  other  two 
classes. 

Sedatives.— -Those  which  have  a  soothing  effect  by 
lowering  functional  activity  (Gould). 

Sialagogues. — Those  which  produce  an  increased 
flow  of  saliva. 

Somnifacients,  Soporifics. —  Those  which  cause 
sleep. 

Sorbefacients. — Medicines  which  cause  absorption. 

Specifics. — Those  which  have  direct  curative  influ- 
ence on  certain  individual  diseases. 

Stimulants.  —  Those  which  increase  functional 
activity. 

Stomachics. — Stimulants  exciting  the  functional 
activity  of  the  stomach. 

Styptics. — The  same  as  haemostatics. 

Sudorifics. — Those  which  produce  sweating. 

Tseniacides. — Drugs  which  kill  tape- worms. 

Tonics. — Those  which  promote  nutrition  and  give 
tone  to  the  system. 

Vesicatories. — Blisters. 

III.  The  preparation  of  medicines  from  the  crude 
drug  is  carried  on  in  drug  mills  and  pharmacies  by 
many  processes  of  great  nicety  and  by  exact  formulae 
which  place  them,  when  completed,  in  distinct  classes, 
each  class  differing  from  all  others  in  one  or  more 
particulars.  To  standardize  the  preparation  of  drugs, 
each  country  has  its  Pharmacopoeia,  or  authorized  pub- 
lication containing  the  list  of"  such  drugs  and  their 
preparations  as  are  declared  official  for  that  country. 
Abroad  the  national  Pharmacopoeias  are  established  by 
law.  In  this  country,  representatives  of  the  medical 
and  pharmaceutical  professions  together  formulate  the 
U.  S.  P.,  and  appoint  a  committee  to  revise  it  every  ten 
years. 

Dispensatories  are  private  unofficial  publications — 
commentaries  on  the  Pharmacopoeia,  treating  with  much 
detail  not  only  those  official  drugs  contained  in  it,  but 


INTRODUCTION. 


unofficial  ones,  and  their  preparations  also.  The  Dis- 
pensatory and  the  Pharmacopoeia  both  give  doses.  The 
classes  of  preparations  of  the  U.  S.  P.  are  as  follows,  a 
few  being  omitted  as  unimportant: 


LIQUID  PREPARATIONS. 

Emulsions,  Emulsa. 
Elixirs,  Elixiria. 
Infusions,  Infusa. 
Solutions,  Liquor es. 
Waters,  Aquez. 
Tinctures,  Tinctures. 
Fluidextracts,  Fluidextracta* 
Spirits,  Spiritus. 
Mixtures,  Misturcs. 
Vinegars,  Aceta. 
Oleates,  Oleata. 
Oleoresins,  Oleoresince. 
Glycerites,  Glycerita. 
Syrups,  Syrupi. 
Mucilages,  Mucilagines. 
Liniments,  Linimenta. 


SOUD  PREPARATIONS. 

Extracts,  Extracta. 
Resins,  Resincs. 
Cerates,  Cerata. 
Pills,  Pilules. 
Powders,  Pulveres. 
Papers,  Charta. 
Ointments,  Unguenta. 
Plasters,  Emplastra. 
Suppositories,  Suppositoria* 
Troches,  Trochisci. 


LIQUID  PREPARATIONS. 

Emulsions. — Liquid  preparations  in  which  oleagin- 
ous substances  are  suspended  in  a  minutely  divided 
state,  by  the  aid  of  gummy  or  viscid  substances,  in 
water.  Four  official. 

Elixirs  are  aromatic  sweetened  vehicles  containing 
alcohol,  syrup,  and  water,  with  various  drugs.  They 
are  very  popular  in  the  United  States  and  are  typical 
of  the  American  method  of  exhibiting  drugs.  Two 
official. 

Decoctions. — Made  by  boiling  the  drug  in  water. 
A  method  used  for  hard  fibrous  or  wood  plants.  They 
are  made  in  a  strength  of  5%  unless  otherwise  directed. 
None  official. 

Infusions. — Made  by  treating  a  vegetable  drug 
with  either  hot  or  cold  water  without  boiling.  Two 


10  MATERIA   MEDICA    FOR   NURSES. 

official.  The  strength  is  the  same  as  that  of  decoc- 
tions. 

Solutions.— Preparations  of  non-volatile  drugs  dis- 
solved in  water.  Twenty-five  official.' 

Waters. — Solutions  of  volatile  principles  dissolved 
in  water.  Eighteen  official. 

Tinctures. — In  the  Eighth  Decennial  Revision  of 
the  Pharmacopoeia,  the  proportion  of  drug  to  the  finished 
tincture  had  been  made  to  conform  to  the  standard 
adopted  at  the  International  Conference,  Brussels,  1902, 
either  ten  or  twenty  per  cent,  by  volume.  There  are, 
however,  exceptions  to  this  general  rule.  There  are 
fifty-four  official  tinctures. 

Fluidextracts. — Concentrated  tinctures  or  alcoholic 
extracts  of  definite  strength.  One  mil  of  a  fluid- 
extract  represents  i  gramme  of  the  drug ;  or,  i  minim 
represents  i  grain,  approximately.  Forty-nine  official. 

Spirits. — Solutions  of  volatile  substances  in  alcohol. 
Fifteen  official. 

Wines. — Preparations  made  with  a  basis  of  wine. 
None  official. 

Mixtures. — Watery  preparations  holding  an  in- 
soluble substance,  finely  subdivided,  in  suspension. 
There  are  two  official  mixtures. 

Vinegars. — Preparations  made  with  dilute  acetic 
acid.  One  official. 

Oleates. — Preparations  made  with  oleic  acid.  One 
official. 

Oleoresins. — Preparations  containing  a  mixture  of 
natural  oils  and  resins  extracted  from  vegetable  sub- 
stances by  the  action  of  acetone.  They  are  the  most 
concentrated  of  liquid  preparations.  Six  official. 

Glycerites. — Preparations  made  with  a  basis  of  gly- 
cerin. Five  official. 

Syrups. — Preparations  made  with  sugar  and  water, 
sometimes  containing  alcohol.  Simple  syrup  is  sugar 
and  water.  Twenty-two  official. 

Mucilages. — Preparations  of  soluble  gummy  sub- 
stances dissolved  in  water.  They  spoil  very  quickly. 
Two  official. 


IN  TROD  UCT1ON.  1 1 

Liniments. — Preparations  for  external  application 
with  friction.  They  have  an  oily  or  soapy  character. 
Eight  official. 


SOLID  PREPARATIONS. 

Extracts. — Semi-solid  or  solid  preparations,  made 
by  evaporation  of  a  solution  of  the  soluble  substances 
of  drugs.  Twenty- five  official. . 

Resins. — Peculiar  substances  soluble  in  alcohol  and 
insoluble  in  water.  It  is  the  resinous  constituent 
which  causes  the  thick  precipitate  seen  when  resinous 
tinctures  are  diluted  with  water.  Such  preparations 
are  better  diluted  with  weak  wine.  Four  official. 

Cerates. — Preparations  made  for  inunction  with 
white  wax.  They  differ  from  ointments  in  that  they 
contain  a  large  portion  of  wax  and  do  not  liquefy  at 
the  body  temperature.  They  are  intended  for  dress- 
ings. Three  official. 

Confections. — Medicinal  substances  prepared  with 
a  mass  of  sugar  and  honey  None  official. 

Pills. — Seven  official.  Need  no  general  descrip- 
tion. 

Powders. — Seven  official.  Need  no  general  de- 
scription. 

Papers. — Papers  impregnated  with  medicinal  sub- 
stances. One  official,  which  is  for  vesication.  The 
word  "charta"  also  means  the  small  papers  in  which 
powders  are  done  up,  or,  by  inference,  the  powder 
itself. 

Ointments. — Preparations  with  a  basis  of  vaseline, 
fixed  oils,  or  lard,  to  be  used  by  inunction.  Twenty 
official. 

Plasters. — Medicinal  substances  mixed  with  lead 
plaster,  wax,  resin  or  gum  resin,  and  spread  upon 
coarse  muslin  or  white  leather,  and  adherent  at  the 
body  temperature  to  the  skin.  Seven  official. 

Troches.— There  are  five  official.  Troches  are 
medicated  lozenges. 


12  MATERIA   MEDTCA  FOR  NURSES. 

Suppositories. — Slender  cone-shaped  appliances  for 
insertion  into  the  rectum,  urethra,  or  vagina.  The 
basis  is  usually  cocoa  butter.  They  should  be  pro- 
tected against  heat  and  moisture. 

Recent  Methods  of  Exhibiting  Drugs. 

Tablets  are  compressed  drugs  which  are  first  granu- 
lated, then  moistened  with  alcohol,  and  rubbed  dry 
through  a  sieve  to  prevent  sticking  to  the  dies  of  the 
machine.  They  are  prepared  in  a  strictly  aseptic  way 
and  are  in  much  demand  because  convenient  in  form 
and  easily  soluble. 

Collapsubes  are  collapsible  tubes  containing  oint- 
ments, creams,  or  lubricants,  used  with  proper  attach- 
ments to  apply  substance  to  the  urethra,  uterus,  rectum, 
and  in  ophthalmic  surgery. 

Solubes  are  substances  put  up  in  soluble  coverings  for 
local  application  as  lotions. 

Sterules  are  glass  capsules  of  sterile  solutions  for 
ophthalmic  and  general  use.  The  ends  are  snipped 
off  at  the  file  marks  |  in.  from  each  end  and  the  fluid 
is  allowed  to  flow  into  the  part  to  be  treated. 

Vescettes  are  effervescent  salts  compressed,  and  are  to 
be  used  by  dissolving  in  water. 

Cachets  consist  of  little  hollowed  discs  of  wafer- sheet, 
so  constructed  that  two  can  be  fastened  together  by 
their  concave  surfaces,  enclosing  a  powder.  The 
cachet  is  dipped  for  an  instant  in  water,  when  it  softens, 
and  is  placed  upon  the  tongue  and  carried  down  by  a 
mouthful  of  water.  Large  doses  of  drugs  in  the  form 
of  powders  may  be  given  in  this  way. 

Lamella  are  small  gelatin  discs  containing  drugs  to 
be  inserted  between  the  lower  lid  and  the  eyeball. 

NOTES  ON  SOLUTIONS. 

Introductory. 

The  making  of  solutions  is  a  phase  of  nursing  pro- 


INTRODUCTION.  13 

cedure  which  necessitates  exact  knowledge  and  careful 
technique.  It  is  essentially  a  pharmaceutical  process 
and  could  be  taught  to  good  advantage  in  the  hospital 
drug  room  by  the  pharmacist,  since  here  only  is  to  be 
found  the  requisite  combination  of  expert  knowledge 
and  suitable  equipment  which  makes  for  efficient  teach- 
ing. By  actually  handling  drugs,  and  by  observation 
under  expert  supervision  of  exact  methods  of  weighing 
and  measuring,  the  nurse  will  more  readily  grasp  the 
underlying  principles  and  realize  the  necessity  for  cau- 
tion and  accuracy. 

Definition. 

A  solution  is  a  liquid  in  which  has  been  dissolved 
particles  of  a  solid,  a  gas,  or  another  liquid,  so  finely 
divided  that  the  resultant  mixture  appears  clear  and 
homogeneous  and  the  dissolved  substance  cannot  be 
seen. 

Saturation. 

A  saturated  solution  is  a  fluid  which  contains  as 
much  of  the  solid  as  it  is  capable  of  dissolving.  If 
more  of  the  solid  be  added,  it  will  not  be  dissolved  but 
will  remain  as  a  sediment.  The  solubility  of  various 
substances  varies  widely:  some  substances,  such  as 
sodium  iodide,  dissolve  readily  in  a  relatively  small 
quantity  of  water;  others,  such  as  salicylic  acid, 
require  a  large  proportion  of  water  and  dissolve  very 
slowly.  The  solubility  of  a  substance  is  affected  chiefly 
by  the  following  factors,  viz.:  (a)  The  nature  of  the  sub- 
stance to  be  dissolved,  (b)  The  nature  of  the  dissolving 
medium,  (c)  The  temperature  of  the  dissolving  medium. 

The  first  point  has  already  been  explained.  To 
illustrate  the  second  point,  it  may  be  stated  that  sub- 
stances which  will  not  dissolve  in  water  at  all  will  dis- 
solve readily  in  alcohol  (ex.  camphor),  and  on  the  other 
hand,  magnesium  sulphate,  which  in  water  dissolves 
with  the  utmost  ease,  remains  undissolved  in  alcohol 


14  MATERIA  MEDICA  FOR  NURSES. 

As  regards  the  third  factor  it  may  be  stated  that,  as  a 
general  rule,  the  higher  the  temperature  of  the  medium, 
the  higher  the  saturation  point — e.  g. ,  the  more  of  the 
solid  may  be  dissolved  in  it.  The  saturation  point  of 
alum  in  cold  water  is  only  10  %,  whereas  if  boiling  water 
be  used  this  is  increased  to  80  %. 

Concentration  of  Solutions. 

By  the  strength  or  concentration  of  a  solution  is 
meant  the  quantity  of  particles  of  a  solid,  a  gas,  or  a 
liquid  which  are  dissolved  in  a  given  quantity  of  that 
solution.  This  may  be  expressed  in  terms  of  percent- 
age— that  is  to  say,  by  stating  the  presence  of  so  many 
parts  of  dissolved  substance  in  every  hundred  parts  of 
solution.  Thus:  a  5%  solution  of  boric  acid  would  con- 
tain five  parts  of  the  solid  drug  to  every  hundred  of 
water.  Solutions  decompose  very  quickly,  and  the  ap- 
pearance of  a  cloudy  growth  shows  that  they  are  no 
longer  fit  to  use. 

Proportion. 

Sometimes  the  strength  of  a  solution  is  designated 
by  stating  that  a  given  quantity,  such  as  an  ounce,  con- 
tains so  many  grains.  Thus:  atropine  solution  grs.  iii. 
ad.  |  i.  The  quantity  of  the  solid  drug  here  used  is 
indicated  by  arbitrary  proportion  and  not  by  percentage. 

On  these  two  arithmetical  procedures,  viz.,  percentage 
and  proportion,  are  based  the  following  methods  of 
working  out  typical  problems  encountered  in  the  mak- 
ing of  solutions. 

Problem  /.—To  estimate  the  amount  of  a  drug  which 
must  be  added  to  a  given  quantity  of  the  dissolving 
medium  in  order  to  make  a  solution  of  a  given  percentage. 

Example. — Let  the  solution  called  for  be  atropine 
5%  one  ounce.  Reduce  quantity  needed  to  lowest 
unit,  viz.: 


INTRODUCTION.  15 

I  i  =  480  m. 

Multiply  result  by  the  rate  per  cent. 
480  x  5  =  2400. 
and  divide  by  100. 
2400  -f-  100  =  24. 

The  result,  viz.,  24  grains,  represents  the  amount  of 
atropine  which  must  be  added  to  i  ounce  of  water  to 
make  a  solution  of  5%. 

A  convenient  practical  rule  for  diluting  a  stronger 
solution  to  one  of  any  given  weaker  strength  is  the 
following: 

Take  number  of  units  indicated  by  solution  desired, 
add  water  to  bring  the  bulk  up  to  number  of  units  in- 
dicated by  original  strength.  Thus,  to  get  a  solution 
of  75%  from  one  of  95%,  take  75  units  of  the  95%  solu- 
tion and  add  20  units  of  water.  The  result  will  be  of 
the  concentration  desired,  viz.  75%. 

Problem  IT. — To  find  the  amount  of  a  stock  solution 
of  known  strength  to  use  in  making  a  given  quantity 
of  a  solution  of  known  different  strength. 

Example. — One  quart  of  bichloride  of  mercury  solu- 
tion i :  3000  is  desired.  The  stock  solution  on  hand  is 
1:25. 

Reduce  quantity  called  for  to  lowest  units. 
i  quart  =  15000  TU.     (Approx.) 
Multiply  result  by  the  weaker  proportion. 

15000    X    3oW     =     5- 

Divide  the  result  by  the  stronger  proportion  : 
5  +*  -  5  X  ¥  =  125. 

The  result,  viz.,  125  fit,  represents  the  quantity  of 
the  1:25  solution  necessary  to  make  the  quantity  called 
for,  viz.,  i  quart. 

Problem  III. — To  make  a  solution  of  known  strength 
from  tablets  of  a  different  known  strength.  This 


1 6      MATERIA  MEDIC  A  FOR  NURSES. 

problem  occurs  especially  in  the  preparation  of  a  drug 
to  be  given  hypodermically  when  the  stock  tablets  on 
hand  require  division  in  order  to  procure  the  dose 
desired. 

Example. — Atropine  gr.  1/120  desired. 
Atropine  gr.  i/ioo  on  hand. 

Calculate  what  proportion  of  reo  is  contained  in  ra>. 
Thus: 

T^  *  rk  =  iio  X  ip  =  I. 

The  resulting  fraction  gives  the  proportion  of  the 
stock  tablet  (gr.  ron)  required,  e.g.  I. 

vSince  the  most  accurate  method  of  dividing  the  tablet 
is  to  dissolve  it  in  a  known  quantity  of  water  and  take 
I  of  the  resultant  solution,  we  may  proceed  thus: 
Add  to  stock  tablet  gr.  i<h>,  TTI  xxx  of  water: 

\  X  30  =  25- 

Problem  IV. — It  is  sometimes  necessary  to  administer 
a  fractional  dose  of  a  drug  when  the  only  preparation 
on  hand  is  a  solution  whose  strength  is  indicated  in 
terms  of  percentage. 

Example. — Strychnine  gr.  A  is  called  for,  the  solution 
on  hand  has  a  strength  of  i% 
Since  Til  100  contains  gr.  i. 
,V  Ut      J  "  rfc.  ^ 

.".  gr.  6ltf  will  be  contained  in  as  many  minims  as 
grain  yfo  is  contained  in  gr.  &>. 

A  -  iJo  =  hao  X  LP  =  2. 

Minims  2  of  the  stock  solution    represents  the 
amount  called  for,  viz. ,  gr.  vs. 

The    foregoing  examples   would   hold    good   for 
modification  of  doses  if  given  by  the  metric  system. 


INTRODUCTION.  17 

To  illustrate  the  procedure  under  these  conditions  the 
following  example  may  be  given: 

Codeine  tablets  gram  0.06  on  hand. 

Dose  required  gram  0.015. 

Demonstrate  the  ratio  of  0.06:  0.015,  viz.  .4. 
.4  (f)  of  the  .06  gram  tablet  will  then  be  needed  to  make 
the  dose  called  for,  viz.  0.015. 

Problem  V. — Estimation  of  child's  dose. 

To  estimate  the  proportional  dose  for  a  child  under 
twelve  years  from  the  adult  dose,  proceed  as  follows: 

Make  a  fraction  by  taking  the  child's  age  as  the  num- 
erator and  the  child's  age  plus  12  as  the  denominator. 
Divide  the  adult  dose  by  the  resulting  fraction. 

Example. — Dover's  powder  grs.  x  represents  adult 
dose. 

Dose  for  child  of  3  years  required. 

__3  _L   v  !2.  ..   a. 

3  +  12          is    "    i 

Dose  for  child  of  three  years  would  be  grs.  ii. 

We  find  the  metals,  as  prepared  for  medicinal  use, 
usually  in  solution,  after  being  changed  in  form  by 
the  action  of  various  other  chemical  agents.  Among 
tinctures,  on  the  other  hand,  are  found  many  of  those 
vegetable  drugs  from  which  are  obtained  the  powerful 
alkaloids.  But  if  the  pure  alkaloids  alone  are  desired, 
as  they  are  insoluble  in  water  and  only  partly  so  in 
alcohol,  they  must  be  treated  as  the  metals  are,  and 
combined  with  an  acid  to  make  them  ready  for  inges- 
tion.  In  this  combination  both  metals  and  alkaloids 
form  what  are  called  "  salts  " — being  perfectly  soluble 
in  water  yet  retaining  all  their  medicinal  qualities. 
Thus  one  reads  of  the  "  salts  "  of  iron,  the  "  salts  "  of 
strychnine,  etc.  Various  acids  are  used,  but  the  most 


18  MATERIA  MEDICA  FOR  NURSES. 

common  one  is  sulphuric  acid,  as  it  is  cheap.  These 
salts  are  then  finally  prepared  for  use  in  solution,  and 
distinguished  from  each  other  by  the  name  of  the  acid 
used — e.  g.,"  the  solution  of  the  sulphate  of  morphine, ' ' 
the  "  hydrochloride  of  cocaine,"  etc. 

As  solutions  are  made  in  varying  strengths,  the  face 
of  the  bottle  is  always  carefully  marked  either  with  the 
percentage  or  with  the  amount  to  the  drachm. 

Many  preparations  of  drugs  are  injured  by  age,  espe- 
cially when  not  securely  corked.  Tinctures  and  fluid- 
extracts  become  stronger  by  reason  of  evaporation  of 
their  alcohol.  Infusions  soon  spoil.  Many  prepara- 
tions are  injured  by  light  and  air,  as  the  silver  solu- 
tions, and  others  are  unstable  as  to  composition. 

Medicinal  agents  may  be  applied  :  (i)  to  the  skin  in 
various  ways,  viz.,  by  inunction,  as  oils,  liniments,  and 
ointments,  rubbed  into  the  skin ;  by  simple  contact 
without  rubbing,  as  medicated  baths,  cooling  or  seda- 
tive mixtures,  blisters,  plasters,  powders,  etc.;  and  by 
painting,  as  iodine ;  (2)  to  mucous  membranes,  as  gar- 
gles, insufflations,  sprays,  and  douches ;  (3)  to  wounds 
and  diseased  tissue,  as  antiseptic  powders,  ointments, 
and  solutions;  or  they  may  be  administered  (4)  by  in-> 
halation,  as  fumes  or  vapor;  (5)  by  hypodermic  injec- 
tion into  the  subcutaneous  tissues;  (6)  by  the  mouth, 
or  by  the  rectum,  into  the  alimentary  canal. 

By  the  first  three  ways,  the  effects  produced  are, 
generally  speaking,  local  (though  in  many  instances 
the  local  impression  may  be  deepened  into  a  general 
one)  and  results  are  slow. 

Inhalation  is  a  rapid  mode  of  impressing  the  system, 
but  only  a  few  drugs  are  fitted  for  use  in  this  way. 

Drugs  given  hypodermically  act  most  promptly,  be- 
cause they  go  directly  into  the  blood  current,  and  are 
diffused  through  the  tissues  in  a  short  time.  Only 
highly  concentrated  or  powerful  agents  which  are 
active  in  small  bulk  can  be  given  in  this  way;  and  of 
these,  many,  otherwise  available,  are  forbidden  on 
account  of  their  irritant  properties. 

Medicines  are  most  often  given  by  way  of  the  ali- 


INTRODUCTION.  1 9 

mentary  canal,  and  the  rectum  is  used  when  for  any 
reason  it  is  not  desirable  to  use  the  stomach. 

Having  entered  the  circulation  by  whatever  route,  a 
drug  is  carried  by  the  blood  to  the  tissues,  and  is  finally 
eliminated,  or  cast  off  as  waste  product,  by  the  excre- 
tory organs. 

As  full  instructions  for  giving  hypodermic  injections 
are  found  in  nursing  text-books,  only  brief  details  of  the 
metnods  used  for  deep  and  superficial  injections  are 
here  given.1  The  measurements  commonly  used  in 
this  country  are  the  minim — TU ,  the  fluid  drachm —  3  , 
and  the  fluid  ounce —  | ,  or  half  ounce —  §  ss. 

The  minim  is  not  by  any  means  the  exact  equivalent 
of  a  drop,  nor  are  all  drops  alike.  A  medicine  ordered 
in  minims  must  not  be  measured  by  drops,  nor  one 
ordered  in  drachms,  by  a  teaspoon. 

It  is  hardly  necessary  to  say  that  the  nurse  should 
always  know  what  she  is  giving,  and  in  what  propor- 
tions. It  is  therefore  essential  that  she  should  learn 
to  read  prescriptions,  to  recognize  the  most  important 
ingredient  or  ingredients  contained  therein,  and  to  find 
out  by  arithmetical  process  the  exact  amount  of  such 
ingredients  contained  in  a  given  dose. 

i^ 

Dosage. 

In  order  to  facilitate  the  learning  of  doses  it  may  be 
advisable  to  become  familiar  with  the  ordinary  dose  of 
the  different  classes  of  drugs. 

Potent  tinctures  are  given  in  doses  of  Hlv.-xv.  (0.3- 
i  mil),  except  the  tincture  of  iodine,  which  is  given  in 
doses  of  Tlli.-iii.  (0.05-0.2  mil). 

Fluidextracts  can  be  given  in  doses  of  fiix.-xx. 
(0.65-1 .3  mils).  Potent  fluidextracts  are  given  in  doses 
of  fT[i.  (0.05  mil). 

Solid  extracts  may  be  administered  in  gr.  i.  (0.06 

1  Pages  278-280. 


2O  MATERIA   MEDIC  A    FOR  NURSES. 

Gm.)  doses.  The  potent  solid  extracts  are  given  in 
gr.  i  (0.015  Gm.)  doses. 

Spirits  may  be  given  in  doses  of  3  ss.  (2  mils),  except 
the  spirits  of  nitroglycerin  TiU.-m.  (0.05-0.2  mil),  and 
the  spirits  of  phosphorus  Ttyx.  (0.65  mil). 

Syrups  are  given  in  doses  of  3  i.  (4  mils);  the  syrup 
of  the  iodide  of  iron  in  doses  of  "nix.-xxx.  (0.65-2.0 
mils) . 

Diluted  acids  may  be  given  in  doses  of  TT],  x.-xxx. 
(0.65-2.0  mils),  well  diluted  and  taken  through  a  glass 
tube.  Dilute  hydrocyanic  (prussic)  acid  is  taken  in 
doses  of  TU  i.-iii. (0.05-0. 2  mil). 

Infusions  and  decoctions  range  in  dose  from  one  to 
two  tablespoonfuls  (15-30  mils).  Infusion  of  digitalis 
is  taken  in  doses  of  3  i.-iv.  (4-15  mils). 


THE  METRIC  SYSTEM. 

This  system  of  weights  and  measures,  first  instituted 
by  the  French,  is  now  in  general  use  on  the  Continent 
of  Europe,  and  is  legalized  in  the  United  States,  where 
it  is  employed  in  certain  departments  of  the  govern- 
ment and  by  scientific  people  at  large.  Most  physi- 
cians and  surgeons  make  use  of  the  system,  particularly 
in  the  prescription  of  medicines  and  in  operating-room 
work.  It  therefore  has  become  necessary  that  a  nurse 
should  understand  it,  while  its  simplicity,  convenience, 
and  accuracy  commend  the  system  to  everyone. 

The  metric  tables  which  most  concern  a  nurse's  work 
are  as  follows: 

Weights. 

i  milligramme  (mg.)  =       o.ooi  gramme. 

i  centigramme  (eg.)  =        o.oi 

i  decigramme  (dg.)  =         o.i 

i  gramme  (Gm.)  =  i.o 

i  decagramme  =  10.0     grammes. 

i  hectogramme  =  100.0 

i  kilogramme  =  1000.0 

Length. 

i  millimeter  (mm.)  =  o.ooi  meter. 

i  centimeter  (cm.)  =  o.oi 

i  decimeter  (dm.)  =  o.i 

i  meter  (m.)  =  i.o          " 

In  describing  dosage  and  quantities  of  fluid  the  term 
cubic  centimeter  has  been  discarded  by  the  U.  S.  P. 
as  the  cubic  centimeter  is  not  an  exact  thousandth  of 
the  milliliter.  The  term  now  used  instead  of  Cc.  is 
"mil,"  the  first  syllable  of  milliliter. 

21 


22  MATERIA  MEDICA  FOR  NURSES. 

Capacity. 

i  milliliter  or  mil  (ml.)  =0.001  liter, 
i  centiliter  (cl.)=  o.oi        " 

deciliter  (dl.)=  o.i 

i  liter  (1.)=  i.o 


In  writing  dosage  or  strengths  according  to  the  metric 
system,  the  numerals  are  written  in  Arabic  characters 
and  are  followed  by  the  proper  abbreviation,  as,  2  mils, 
i  Gm.  The  abbreviation  for  gramme  has  always  a 
capital  to  distinguish  it  from  gr.  But  in  writing  by 
the  apothecaries'  system  Roman  numerals  are  employed 
after  the  symbol  or  abbreviation,  as  3  i-,  gr.  i. 

The  primary  unit  of  the  metric  system  is  the  meter, 
(39.37  inches),  which  is  approximately  one  ten-millionth 
part  of  the  distance  from  the  equator  to  the  north  pole; 
and  from  this  as  a  basis  the  units  of  weight  and  ca- 
pacity are  readily  derived,  the  remaining  measurements 
in  each  table  being  obtained  from  their  units  by  decimal 
subdivision  and  multiplication.  It  will  be  observed 
that  any  term  less  than  the  unit  is  expressed  by  the 
aid  of  a  I^atin  prefix  (ded,  centi,  mitti),  while  Greek 
prefixes  (deka,  hecto,  kilo)  express  multiplication,  or 
terms  greater. 

To  mention  the  correspondence  between  the  metric 
denominations  and  those  of  the  United  States  currency, 
which  is  a  metric  currency,  may  serve  to  make  under- 
standing more  clear.  It  will  be  noticed  that  meters — 
for  instance — correspond  to  dollars^  decimeters  to  dimes, 
centimeters  to  cents  >  and  millimeters  to  mills.  Some- 
what analogous  to  our  method  of  reading  currency  is 
that  of  reading  the  metric  system  generally. 

For  instance  in  the  figures  $5.25  we  have  represented 
dollars  and  cents,  the  latter  being  equal  to  -ffo  of  a  dol- 
lar. Similarly  in  the  metric  system  these  figures  would 
stand  for  5  and  •££$  of  whatever  the  measure  might  be 
— whether  of  length  or  of  capacity. 

Practical!}',  of  the  table  of  capacities  the  liter  and  its 


THE  METRIC  SYSTEM.  23 

multiplications  only  are  used,  as  the  mil  is  more  con- 
venient for  small  quantities.  Formerly,  instead  of  the 
liter,  the  term  1000  Cc.  was  employed.  The  cubic  cen- 
timeter (Cc.),  centimeter  (Cm.),  and  gramme  (Gm.) 
are  the  terms  the  nurse  most  often  meets  with.  The 
method  of  obtaining  the  gramme,  the  unit  of  the 
standard  for  weighing  both  solids  and  liquids,  has 
been  explained. 

Apothecaries'  Weight. 

20  grains  =  i  scruple  =  3 
60  grains  =  i  drachm  =  3 
8  drachms  =  i  ounce  =  |  =  480  gr. 
12  ounces  =  i  pound  =  Ib.  =  5760  gr. 

Wine  Measure. 

60  minims  =  i  fluid  drachm  =  3 
8  fluid  drachms  =  i  fluid  ounce  =  J 

1 6  fluid  ounces  =  i  pint  =  O. 
8  pints  =  i  gallon  =  gal. 


Common  Measure  and  Metric  Equivalents. 


grain  = 
ounce  Troy  = 
pound  avoirdupois 
fluid  drachm  = 
fluid  ounce  = 
pint  = 
inch  = 


gramme  = 

cubic  centimetre  = 

liter  = 

i  centimeter  = 
i  meter  = 


0.065 
31-103 

=    453.600   ' 
4  mils. 
30    " 
480     " 

2.539  Cm. 
15.432  grains. 

2.204  Ihs.  avoirdupois* 
16.23  minims. 
33.81  fluid  ounces. 

0.393  inch. 
39.37  inches. 


MATERIA  MEDIC  A   FOR  NURSES. 


Approximate  Equivalents. 


4  mils  = 
30  mils  = 
gramme  = 
decigramme  = 
centigramme 
milligramme 
liter  = 
kilo  = 
cm.  = 


15  minims. 
i  fluid  drachm. 
i     '  *     ounce. 
J5i  grains. 

i  \  grains, 
t  grain. 
-fa  grain. 

i  quart. 

2^  Ibs.  avoirdupois. 

I  inch. 


To  obtain  the  number  of  grammes,  approximately, 
reduce  the  quantity  to  grains  and  divide  by  15.  Or 

Reduce  the  quantity  to  drachms  and  multiply  by  4; 
and  proceed  on  like  principles  with  other  denominations. 

It  may  be  interesting  to  note  how  often  15  or  some 
multiple  of  15  comes  into  use  in  measuring  medicine  by 
the  metric  system  or  in  the  ordinary  way.  Thus,  i 
grain  is  equal  to  about  60  milligrammes;  15  grains  are 
equal  to  about  I  gramme;  60  minims  are  equal  to  i 
drachm,  or  a  teaspoonful,  or  about  4  grammes;  30 
grammes  are  equal  to  about  i  ounce;  and  15  milli- 
grammes are  equal  to  about  i  tablespoonful.  For  one 
who  is  accustomed  to  the  use  of  the  ordinary  measures 
only  three  of  these  equivalents  will  be  necessary  in 
order  quickly  and  easily  to  transfer  doses  from  one 
system  to  the  other.  These  are: 

i  gr.  =  60  milligrammes,  approximately. 
15  gr-  =   i  gramme 
i  §  =    30  grammes 

The  following  approximate  equivalents  may  be  used: 

4  mils  =  i  fluidrachm  =  i  teaspoonful  =:  60  minims. 

8  mils  =  2  fluidrachms  =  i  dessertspoonful  =  120 
minims. 

15  mils  =  4  fluidrachms  =  i  tablespoonful  =  240  minims 
(U.  S.  P.,  ix.,  p.  li.). 


Table  showing  quantities  from  five  grains  down,  ac- 
cording to  the  old  tables,  with  their  equivalents  under 
the  metric  system: 


Grains 

Grammes. 

in  decimal  fractions. 

in  common  fractions 
(approximate). 

0.324 

5 

5 

0.291 

4-5 

4i 

0.259 
O.226 

3-5 

0.194 

3 

3 

O.I62 

2.5 

0.130 

2 

2 

0.097 

'•5 

H 

0.065 

i 

i 

0.061 

0.94 

if 

0.060 

0.93 

T»T 

0.057 

0.88 

| 

0.053 

0.82 

H 

0.050 

0.77 

m 

0.049 

0.76 

I 

0.045 

0.69 

Tf 

0.040 

0.62 

u 

0.036 

0.56 

$r 

0.032 

0.5 

i 

0.028 

0.43 

0.025 

0.39 

f 

0.024 

0.37 

0.020 

0.31 

0.016 

0.24 

O.OI2 

0.18 

. 

0.008 

0.12 

0.004 

0.06 

0.0032 

0.05 

0.0027 

0.04 

O.O022 
O.OOlS 

0.033 

0.028 

0.0016 

0.025 

0.0013 

O.02 

O.OOII 

O.OI7 

ft 

O.OOI 

0.015 

«¥ 

0.0006 

O.OI 

TTTF 

0.0005 

0.008 

iks 

0.0004 

0.0065 

0.0003 

0.005 

T^D 

O.0002 

0.003 

TJT7 

0.0001 

0.0015 

7^ff 

A  CLASSIFICATION  OF  REMEDIES 

ACCORDING  TO  THEIR 
PROMINENT  THERAPEUTICAL  ACTIONS. 

This  classification  of  the  Materia  Medica,  being  de- 
signed for  the  use  of  nurses,  follows  the  order  in  which 
Anatomy  is  commonly  taught  in  training  schools  for 
nurses,  as  it  is  thought  that  the  study  of  those  reme- 
dies most  frequently  employed  in  diseases  of  the  various 
systems  of  the  body,  taken  in  conjunction  with  the 
anatomy  and  physiology  of  each  system,  may  induce  a 
clearer  comprehension  of  both  our  Materia  Medica  and 
Anatomy,  and  at  the  same  time  serve  to  fix  both  in  the 
mind. 

THE  CIRCULATORY  SYSTEM. 
Drugs  Acting  on  the  Heart, 

Cardiac  Tonics, — increase  force  of  heart's  contraction, 
lessening  frequency. 

Strychnine.     Digitalis.    Arsenic. 
Rest.    Graded  Exercise.     Food. 

Also  iron,  iodides,  mercury,  caffeine,  adonis  vernalis, 
convallaria,  fresh  air  in  carriage,  cheerfulness,  encour- 
agement, Schott  baths,  cupping,  bleeding,  purging, 
counter-irritation,  douches,  etc. 

Cardiac  Stimulants, — increase  both  force  and  number 
of  heart  beats. 

Ether.     Digitalis.     Belladonna. 

Counter-irritation  to  praecordia. 

Carminatives  (Red  Pepper.    Ginger.) 

Also  strophanthus,  squills,   sparteine,  camphor,   am- 

26 


A  CLASSIFICATION  OF  REMEDIES.  27 

monia  hyoscyamus,  stramonium,  amyl  nitrite,  strych- 
nine, chloroform,  ammonia  to  5th  nerve,  cold  douche, 
flagellation,  cupping,  leeching,  food,  air,  good  diges- 
tion, active  liver,  cold  weather. 

Normal  salt  solution,  one  of  the  most  efficient  cardiac 
stimulants,  has  only  a  mechanical  action,  supplying  a 
fluid  of  the  same  specific  gravity  as  the  blood,  which 
the  heart  pumps  upon  until  the  natural  circulation  is 
restored. 

Cardiac  Sedatives, — lessen  force  and  frequency  of  pulse. 

Opium.    Aconite.    Potassium. 
Venesection.    Purgatives. 

Also  hydrated  chloral,  veratrine,  antimony,  dilute 
hydrocyanic  acid,  ergot,  alcohol,  chloroform  (late 
effect),  ipecac,  physostigmine,  conium,  low  diet,  diu- 
retics, arrest  sensory  impressions  (warm  bath),  diapho- 
retics, warm  weather. 


Drugs  Acting  on  the  Vessels. 

Vascular  Stimulants ', — dilate  the  vessels  through  the 
vasomotor  centres,  equalizing  blood  pressure. 

Nitroglycerin.    Amyl  Nitrite.    Alcohol. 
Also  lobelia,  ether,  belladonna,  liquor  ammonii  acetatis. 

Local  Stimulants  (on  skin), — dilate  the  vessels  by  local 
action. 
Heat  (poultices,  fomentation).    Acrid  Oils  (mustard). 

Also  volatile  oils  (turpentine,  camphor),  irritant  metals 
(zinc,  copper,  iron),  carbon  compounds  (creosote, 
phenol,  etc.),  and  pepper. 

Vascular  Sedatives.    See  Haematinics  and  Antiphlogis- 
tics. 


28  MATERIA  MEDICA  FOR  NURSES. 

THE  RESPIRATORY  SYSTEM. 
Drugs  Acting  on  Respiration. 

Respiratory  Stimulants, — stimulate  respiration  by  ac- 
tion on  brain  centres. 

Strychnine.    Ammonia.    Atropine. 

Also  aconite,  belladonna,  hyoscyamus,  stramonium, 
camphor,  caffeine,  and  cocaine.  Alcohol,  ether,  and 
chloroform  in  first  stages. 

Respiratory  Depressants, — lower  action  of  respiratory 
centre. 

Heroine.     Hydrated  Chloral.     Chloroform. 

Also  opium,  ether,  alcohol,  antimony,  and  hydrocyanic 
acid. 

Drugs  Acting  on  the  Bronchial  Tubes. 

Pulmonary  Sedatives ', — relieve  cough  and  dyspnrea. 
Heroine.    Opium.     Hydrocyanic  Acid. 

Also  codeine,  hydrated  chloral,  bromides,  oil  of  turpen- 
tine, belladonna,  hyoscyamus,  cannabis  indica,  chloro- 
form, and  wild  cherry. 

Expectorants, — modify  bronchial  secretion  and  aid  its 
expulsion. 

(i)  Depressant  Expectorants. 

Antimony.     Ipecac.     Alkalies. 

Also  apomorphine,  iodides,  and  general  depressants, 
as  opium,  hydrated  chloral,  etc. 


A  CLASSIFICATION  OF  REMEDIES.  29 

(2)  Stimulant  Expectorants. 
Ammonium  Chloride.    Ammonium  Carbonate.     Squill. 

Also  balsam  of  Peru,  balsam  of  tolu,  creosote,  senega, 
benzosol,  aromatic  oils,  acids,  and  syrups. 

Inhalations, — used  to  stimulate  the  bronchi,  disinfect 
secretions,  or  relieve  spasms. 

Benzoin.     Creosote.     Amyl  Nitrite. 

Also  turpentine,  oil  of  eucalyptus,  stramonium,  conium, 
chloroform,  tobacco,  nitre  paper,  steam. 

THE  DIGESTIVE  SYSTEM. 
Drugs  Acting  on  the  Salivary  Glands. 

Sialagogues, — increase  flow  of  saliva. 

Pilocarpus.     Mercurials.    Acids. 

Also  tobacco,  ether,  pungents,  iodine,  physostigmine, 
antimony,  and  ipecac. 

Anti-Sialagogues, — decrease  flow  of  saliva. 
Atropine.    Opium.    Alkalies. 

Also  belladonna,  hyoscyamus,  stramonium,  tobacco  in 
excess,  and  all  nauseous  or  insipid  stuffs. 

Refrigerants, — allay  thirst  and  create  coolness. 

Cool  Drinks.     Dilute  Acids.    Cold  Externally. 

Also  fruit  juices,    many   diaphoretics,  and  cold  per 
rectum  or  vagina. 

Drugs  Acting  on  the  Stomach. 

Emetics, — cause  vomiting. 

Stomach  Tube.    Warm  Water.    Apomorphine, 
Also  mustard,  soapsuds,  or  salt  and  warm  water,  tartar 


30  MATERIA  MEDICA  FOR  NURSES. 

emetic,  ipecac,  zinc  or  copper  sulphate,  alum,  infusion 
of  camomile,  and  ammonium  carbonate. 

Anti- Emetics, — relieve  nausea  and  vomiting. 
Quiet.     Morphine.    Cerium  Oxalate. 

Also  bromides,  chloral,  cocaine,  creosote,  carbolic  acid, 
iodine,  lime  water,  ice,  bismuth  subnitrate,  chloro- 
form, hydrocyanic  acid,  ipecac  (in  small  doses),  and 
alcohol. 

Carminatives, — aid  in  expulsion  of  gas  from  stomach 
and  intestines. 

Capsicum.    Ginger.    Peppermint. 

Also  asafcetida,  camphor,  cardamom,  cinnamon,  musk, 
cloves,  Hoffman's  anodyne,  spirits  of  chloroform,  dilute 
sulphuric  acid,  and  pungent,  spirituous,  and  aromatic 
stomachics. 

Gastric  Tonics  or  Stomachics, — excite  the  functional  ac- 
tivity of  the  stomach,  and  thus  increase  appetite  and 
aid  digestion. 

Nux  Vomica.    Dilute  Acids.    All  Alkalies. 

Also  gentian,  quassia,  cinchona,  calumba,  hydrastis, 
eucalyptus,  wild  cherry,  cascarilla,  taraxacum,  aloes, 
rhubarb,  pepsin,  pancreatin,  and  alcohol. 

Gastric  Sedatives, — relieve  pain  and  quiet  the  stomach. 
Bromides.    Silver  Nitrate.    Phenol  and  Iodine. 


Drugs  Acting  on  the  Intestines. 

Cathartics  or  Purgatives, — hasten  intestinal  evacuation, 
(i)  Laxatives  or  Aperients, — of  moderate  action. 
Manna.    Cascara.     Prunes. 

Also  figs,    tamarinds,    molasses,   sulphur,    magnesia, 
glycerin,  olive  oil,  and  water. 


A  CLASSIFICATION  OF  REMEDIES.  31 

(2)  Simple  Purgatives, — produce  active    peristalsis 
(and  griping  pain). 

Castor  Oil.    Senna.    Aloes. 

Also  cascara,  rhubarb,  glycyrrhiza,  liquorice,  eupato- 
rium,  and  small  doses  of  drastic,  saline,  and  cholagogue 
purgatives. 

(3)  Drastic  Purgatives,  —  intense    action  ;    watery 
stools ;  much  pain. 

Elaterium.     Croton  Oil.     Compound  Cathartic  Pills. 

Also  aloes,  colocynth,  gamboge,  jalap,  podophyllum, 
and  scammony. 

(4)  Saline  Purgatives  or  Hydragogues, — slight  pain  ; 
very  watery  evacuation. 

Epsom  Salt.    Seidlitz  Powder.     Rochelle  Salt. 

Also  sodium  sulphate,  magnesium  citrate,  sodium 
phosphate,  cream  of  tartar,  and  saline  waters. 

(5)  Cholagogue  Purgatives •, — remove  bile  from  the  in- 

testines. 

Calomel.     Podophyllum.     Sodium  Phosphate. 

Also  blue  mass,  gray  powder,  iris,  euonymus,  fel  bovis, 
and  scammony. 

(6)  Intestinal  Antiseptics, — destroy  low  organisms  ; 
check  fermentation  (antizymotics). 

Salol.     Naphthalene.     Thymol. 

Also  beta  naphthol,  benzosol,  silver  nitrate,  oil  of  tur- 
pentine. 

Anthelmintics, — destroy  (vermicides}  or  expel  (vermi- 
fuges) intestinal  worms. 

(i)  Tape-worm. 

Filix  Mas  (ff.  P.).    Cusso.     Pepo. 

Also  turpentine,  thymol,  pelletierine,  kamala,  and  gra- 
natum. 


32  MATERIA  MEDIC  A  FOR  NURSES. 

(2)  Round  worm. 

Santonin.     Spigelia.    Senna. 

(3)  Thread- worm. 

Quassia.    Alum.    Sodium  Chloride. 

Also  tannin,  calumba,  lime  water,  and  vinegar  (by 
enema). 

(4)  Hook-worm. 

i.  Calomel.    2.  Thymol.    3.  Epsom  Salts. 

THE  NERVOUS  SYSTEM. 
Drugs  Acting  on  the  Spinal  Cord  and  Nerves. 

Spinal  Stimulants  and  Motor- Excitants, — stimulate  cells 
of  spinal  cord;  act  on  motor  nerves;  increase  reflex 
excitability. 

Strychnine.    Ammonia.    Ether. 

Also  picrotoxin  (on  medulla),  ergot,  and  alcohol. 

Spinal  and  Motor  Depressants,— lower  the  activity  of 
spinal  cord  and  motor  apparatus. 

Bromides.    Gelsemium.     Chloral. 

Also 
bacco 


atropine,  amyl  nitrite,  physostigmine,  lobelia,  to- 
,  alcohol,  ether  and  chloroform,  cocaine. 


Drugs  Acting  on  the  Brain  and  Nerves. 

Cerebral  Stimulants, — increase  the  activity  of  the  brain, 
most  of  them  producing  delirium  if  taken  in  large 
doses.     Some  (as  alcohol)  are  narcotics  at  last. 
Caffeine.     Coca.     Camphor. 

Also  cannabis  indica,   guarana,   cocaine,   belladonna, 
stramonium,  hyoscyamus,  theobromine,  and  alcohol. 


A  CLASSIFICATION  OF  REMEDIES.  33 

Cerebral  Depressants^ — lower  or  suspend  the  activity  of 
the  brain. 

(1)  Hypnotics  or  Soporifics, — produce  sleep. 

Hydrated  Chloral.     Bromides.     Opium. 

Also  paraldehyde,  sulphonal,  trional,  somnal,  amylene 
hydrate,  hyoscine,  exalgine,  and  urethane. 

(2)  Narcotics, — intensified  hypnotic  power. 
Cannabis  Indica.     Bromal  Hydrate.    Chloretone. 

Also  opium  and  other  drugs. 

Anesthetics, — produce  insensibility  to  pain. 

(1)  General  Anesthetics. 

Ether.    Chloroform.     Nitrous  Oxide. 

Also  alcohol,  and  many  derivatives  of  alcohol  and  ether, 
Schleich  mixtures,  ACE  mixture,  ethyl  bromide, 
pental,  and  bromoform. 

(2)  Local  Anesthetics. 

Cocaine.     Ethyl  Chloride.    Eucaine  B. 

Also  ethyl  hydrate,  orthoform,  carbolic  acid,  cold, 
sterile  water,  holocaine,  ether. 

Anodynes  or  Analgesics, — terms  applied  to  drugs  that 
relieve  mild  pain. 

(1)  General  Anodynes. 

Acetanilide.    Opium.    Bromides. 

Also  phenacetine,  antipyrine,  all  narcotics,  and  many 
hypnotics. 

(2)  Local  Anodynes. 

Cold  or  Heat.    Aconite.    Menthol. 

Also  belladonna,  stramonium,  carbolic  acid,  cocaine, 
chloroform  and  other  liniments,  chloral,  camphor,  and 
opium, 

3 


34  MATERIA  MEDICA  FOR  NURSES. 

Antispasmodics, — prevent  or  relieve  spasm  of  muscle  by 
action  on  nerve  centres. 

Amyl  Nitrite.    Ether.    Bromides. 

Also  potassium  nitrate,  chloroform,  chloral,  camphor, 
conium,  aromatic  oils,  asafoetida,  valerian,  alcohol, 
musk,  belladonna,  stramonium,  hyoscyamus,  lobelia, 
and  opium. 

THE  URINARY  ORGANS. 
Drugs  Acting  on  the  Kidneys. 

Diuretics, — increase  the  quantity  of  urine. 

(1)  Cardiac, — increase  the  flow  of  urine  by  action 

on  heart,  and  general  and  local  circulation. 

Digitalis.    Alcohol.     Squills. 
Also  strophanthus,  spirits  of  nitre,  and  convallaria. 

(2)  Renal, — increase  flow  of  urine  by  action  on 

kidneys. 

Salines.     Buchu.     Copaiba. 

Alsocubeb,  sandalwood,  capsicum,  juniper,  turpentine, 
cantharides,  taraxacum,  zea  mays,  uva  ursi,  and 
eucalyptus.  Salines  are  potassium  acetate,  citrate, 
nitrate,  and  bitartrate,  and  sodium. 

(3)  Combined  Cardiac  and  Renal, — act  on  heart, 
blood-vessels,  and  kidneys. 

Caffeine.     Diuretin.    Water. 

Also  theobromine,  scoparus,  calomel,  beer,  and  gin. 

(4)  Urinary  Alkalinizers> — render  the  urine  alka- 
line. 

Salts  of— 
Potassium.    Sodium.    Lithium. 

(5)  Urinary  Addifiers, — render  the  urine  acid. 

Benzoic  Acid.    Salicylic  Acid. 


A  CLASSIFICATION  OF  REMEDIES.  35 

Drugs  Acting  on  the  Bladder. 

Vesical  Sedatives  or  Tonics, — improve  the  condition  of 
the  muscle  and  mucous  membrane  of  bladder  and 
urethra,  reducing  inflammation. 

Copaiba.      Salol.     Urotropin. 

Also  cubeb,  buchu,  zea  mays,  eucalpytus,  opium,  bella- 
donna, hyoscyamus,  strychnine,  salts  of  potassium 
and  lithium,  and  local  antiseptic  and  astringent  ap- 
plications. 

THE  GENERATIVE  ORGANS. 

EmmenagogueS) — restore  or  regulate  the  menstrual 
flow.  Most  of  them  are  tonic  and  sedative  to  the 
uterus  and  ovaries. 

Viburnum  Prunifolium.     Iron.    Aloetic  Purgatives.     Savine. 

Also  hydrastis,  apiol,  pulsatilla,  ergot,  myrrh,  oil  of  rue, 
tansy.  Indirect  tonics — strychnine,  manganese,  cod- 
liver  oil,  hot  hip  bath,  foot  bath. 

Ecbolics  or  Oxytocics, — cause  contraction  of  the  gravid 
uterus  or  of  the  uterus  following  childbirth. 

Ergot.    Quinine.    Savine. 
Also  rue,  hydrastis,  and  cotton-root  bark. 

Uterine  Depressants •, — restrain  contraction  of  the  uterus. 

Viburnum  Prunifolium.    Opium.    Chloral. 
Also  bromides,  chloroform,  and  cannabis  indica. 

Galadagogues, — increase  the  secretion  of  milk. 
Pilocarpus.    Fluids.    Milk.    Leaves  of  Castor  Oil  Plant. 

Antigaladagogues, — decrease  the  secretion  of  milk. 
Belladonna.     Camphor. 


36  MATERIA  MEDICA   FOR  NURSES. 


THE  SKIN. 

Diaphoretics, — increase    the    secretion   of  sweat.     In- 
directly they  aid  the  kidneys  and  reduce  temperature. 
Pilocarpine.     Dover's  Powder.    Acetanilide. 

Also  salicylates,  nitrous  ether,  antimony,  eupatorium, 
potassium,  ammonium,  camphor,  alcohol,  heat,  antipy- 
rine,  asaprol,  and  other  synthetics. 

Anhidrotics, — diminish  secretion  of  sweat. 

Atropine.    Hyoscyamus.     Picrotoxin.    Cold. 

Irritants. — Many  drugs  when  applied  to  the  skin  pro- 
duce vascular  excitement  or  irritation;  called  counter- 
irritants  if  applied  to  excite  reflex  influence  at  a 
remote  point. 

(1)  Rubefacients, — cause  redness  of  the  skin. 

Mustard.    Heat.    Turpentine. 

Also  ammonia,  capsicum,  camphor,  veratrine,  iodine, 
arnica,  friction. 

(2)  Vesicants  or  Epispastics, — produce  blisters,  or 
collections  of  serum  beneath  the  epidermis. 

Cantharides.     Mustard. 

(3)  Pustulants, — produce  pustules,  or  small  collec- 

tions of  white  blood  corpuscles. 
Croton  Oil.    Tartar  Emetic. 

Caustics  or  Esckarotics, — destroy  the  vitality  of  the 
tissues,  producing  a  slough. 

Nitrate  of  Silver.    Caustic  Potash.    Sulphuric  Acid. 

Also  zinc  chloride,  mercury,  copper,  chloride  of  ant^- 
mony,  bromine,  lime,  caustic  soda ;  acids — carbolic 
nitric,  acetic  (glacial). 

Astringents, — produce  contraction  of  vessels  and  tissue 
and  lessen  secretion  from  mucous  membrane.  Known 
as  remote  or  local  astringents  according  as  they  act 


A  CLASSIFICATION  OF  REMEDIES.  37 

on  internal  organs  or  affect  the  part  to  which  they 
are  applied.  As  they  chiefly  affect  the  vessels  they 
may  also  be  considered  in  relation  to  the  circulation. 

Tannic  Acid.     Alum.     Iron. 

Also  gallic  acid  ;  substances  containing  tannic  acid,  as 
galls,  hamamelis,  catechu,  etc.;  acetic  acid ;  salts  of — 
lead,  silver,  zinc,  copper,  bismuth. 

Antiphlogistics, — agents  reducing  or  subduing  inflam- 
mation or  fever  (Gould).  They  include  all  medicines 
and  means  to  this  end. 

Styptics  or  Hcemoslatics, — arrest  haemorrhage. 
Adrenalin.    All  Astringents.     Cold. 

Also  ergot,  strychnine,  digitalis,  actual  cautery,  heat. 

Emollients  and  Demulcents, — soften  and  protect  skin  or 
mucous  membranes. 

Vaseline.    Cacao  Butter.    Borax. 

Also  olive  oil,  lanolin,  lard,  glycerin,  starch,  lycopo- 
dium,  licorice,  white  of  egg,  barley  water,  rice  water, 
flax  seed,  tragacanth,  acacia,  and  other  mucilaginous 
substances. 

Protectives, — used  to  cover  a  part. 

Collodion.     Guttapercha,  etc. 


THE  EYE. 

Mydriatics,  —  cause  dilatation    of  the    pupil  of   the 
eye. 

Atropine.     Duboisine.    Cocaine. 

Myotics> — contract  the  pupil. 

Physostigmine  (Eserine).    Opium,  etc. 


38  MATERIA  MEDIC  A   FOR  NURSES. 

SUBSTANCES     HAVING     GENERAL     SYS- 
TEMIC EFFECT  ON  BLOOD  AND  TISSUE. 

Restoratives, — promote  constructional  tissue  change. 

(1)  Foods, — supply  new   material   for   repair  and 
oxidation. 

Proteids.     Carbohydrates.     Fats.     Salts.     Water. 

Including  albumins,  starches,  sugars,  sodium  chloride 
calcium  phosphate;   oils — olive,  cod-liver;  alcohol  and 
other  substances. 

(2)  Hcematinics, — increase   the   haemoglobin  (red 
coloring  matter)  in  the  blood. 

Iron.     Manganese. 

(3)  Tonics, — promote  nutrition  and  give  tone  to  the 
system. 

Strychnine.     Iron.    Arsenic. 

Also  quinine,  vegetable  bitters,  phosphates,  hypophos- 
phites,  cod-liver  oil;  acids — hydrochloric,  nitro-hydro- 
chloric,  phosphoric,  lactic,  citric;  salicin,  and  other 
drugs. 

Alteratives, — by  some  unknown  process  alter  morbid 

conditions  and  improve  the  nutrition  of  the  body. 

Mercury.     Arsenic.     Iodine. 

Also  antimony,  gold  and  sodium  chloride,  sarsaparilla, 
colchicum,  cod-liver  oil. 

A ntipyretics,  —-reduce  fever  (i)  by  promoting  loss  of 
heat  and  (2)  by  lessening  its  production. 

Cold.    Acetanilide.    Quinine. 

Also  antipyrine,  salicylic  acid,  guaiacol,  resorcin, 
phenacetine,  aconite,  chinoline,  asaprol,  and  others. 

Antiperiodics, — lessen  the  severity  or  prevent  the  return 
of  certain  periodically  recurring  diseases. 

Quinine.    Fydrast'ne.     Eucalyptus. 


A   CLASSIFICATION  OF  REMEDIES.  39 

ANTISEPTICS  AND  DISINFECTANTS. 

Antiseptics, — arrest  the  growth  of  or  destroy  micro- 
organisms. 

Disinfection, — relates  to  the  complete  destruction  of  the 
organism. 

Formaline.    Bichloride  of  Mercury.     Sulphurous  Acid. 

Also  carbolic  acid,  boric  acid  and  borax,  chloride  of 
zinc,  oxalic  acid,  permanganate  of  potassium,  salicylic 
acid,  peroxide  of  hydrogen,  oil  of  eucalyptus,  thymol, 
quinine,  bismuth,  iodoform,  europhen,  benzoin,  lysol, 
aristol,  dermatol,  pyrogallol,  chlorine,  naphthalene, 
lime,  creolin,  and  others. 

Deodorants, — remove  disagreeable  odors. 

Potassium  Permanganate.    Chloride  of  Lime.    Chlorinated 
Soda.    Charcoal,  and  many  others. 

Parasiticides, — destroy  parasites  on  the  skin. 

Staphisagria.    Picrotoxin.    Ichthyol.    Mercurials.    Sulphur. 
Ether.    Alcohol.    Carbolic  Acid. 


TEXT-BOOK  OF  MATERIA  MEDICA 
FOR  NURSES. 


PART  I. 

THE  INORGANIC   MATERIA   MEDICA. 

THE  ALKALIES  AND  ALKALINE  EARTHS. 

THE  word  "alkali"  is  formed  from  two  Arabic 
words,  "  al,"  meaning  "  the,"  and  "  kali,"  the  name 
of  a  plant  from  the  ashes  of  which  soda  was  obtained. 

Chemically,  an  alkali  is  one  of  a  class  of  caustic 
bases,  the  term  "base"  being  given  to  the  principal 
element  of  a  compound.  The  chief  characteristics  of 
an  alkali  are  comparatively  well  known :  it  unites  with 
oils  and  fats  to  form  soaps;  neutralizes  acids  and  forms 
with  them  fresh  compounds  known  as  salts,  which 
possess  properties  differing  from  those  of  either  con- 
stituent; turns  red  litmus  paper  blue;  and  is  soluble  in 
water. 

Those  alkalies  which  are  obtained  in  a  solid  state, 
viz.,  soda  and  potash,  are  termed  "  fixed,"  while  am- 
monia, by  reason  of  its  gaseous  nature,  is  called  a 
"volatile"  alkali. 

An  Alkaloid  is  an  alkaline  principle  found  in  the 
tissues  of  plants  or  animals,  or  prepared  synthetically  in 
the  laboratory;  more  soluble  in  alcohol  than  in  water, 
and  having  a  definite  composition  as  regards  the 

40 


THE  ALKALIES  AND  ALKALINE  EARTHS.   41 

proportions  of  its  chemical  elements.  This  composi- 
tion is  different  from  that  of  an  alkali.  An  alkaloid  also 
unites  with  acids  to  form  salts,  and  these  salts  have  the 
same  physiological  and  therapeutic  actions  as  the  alka- 
loid and  are  nearly  all  soluble  in  water. 

Salt  Action  or  Ion  Action. 

The  alkalies  and  their  combinations  with  acids,  form- 
ing salts,  act  in  the  system  in  a  different  way  from  the 
animal  or  vegetable  drugs  or  the  metals.  When  the 
salts  are  taken  into  the  stomach  and  intestines  there  is 
set  up  a  process  of  osmosis,  diffusion,  and  filtration^ 
while  the  secretory  activity  of  the  mucous-membrane 
cells  in  these  organs  is  increased,  and,  as  a  result  of 
these  various  actions,  water  is  diverted  from  the  blood 
into  the  stomach  and  intestines,  at  the  same  time  that 
a  portion  of  the  salt  is  absorbed.  Later  the  fluid  and 
salt  are  all  absorbed  in  the  case  of  the  chlorides,  iodides, 
and  bromides,  this  being  accomplished  readily.  The 
carbonates,  tartrates,  citrates,  phosphates,  and  sul- 
phates are  less  readily  absorbed,  the  last  two  being 
very  difficult  of  absorption.  The  alkalies  also  vary  in 
their  rate  of  absorption,  magnesium  being  very  difficult 
of  absorption.  This  enables  one  to  understand  why 
magnesium  sulphate  (Epsom  salt)  is  a  good  purgative. 

The  following  list  shows  the  rate  of  absorption  of  the 
various  alkalies  and  salts,  those  most  rapidly  absorbed 
being  given  first,  the  rate  decreasing  in  order  as  given: 


1  Ammonium 

2  Sodium 

3  Potassium 

4  Lithium 

5  Calcium 

6  Magnesium 


1  Chlorides 

2  Carbonates 

3  Citrates 

4  Tartrates 

5  Phosphates 

6  Sulphates 


The  action  of  the  saline  purgatives  is  considered  to 
take  place  in  this  manner:  When  the  salt  enters  the 
stomach  and  passes  into  the  intestines,  very  little  if 


42  MATERIA  MEDICA   FOR  NURSES. 

any  of  it  is  absorbed,  but  a  great  deal  of  water  is  ex- 
tracted from  the  blood  by  osmosis,  diffusion,  and  filtra- 
tion. This  distends  the  intestines,  increases  peristalsis, 
and  the  contents  of  the  bowel  is  liquefied  and  evacuated. 
The  blood  then  repletes  itself  from  the  tissues.  Should 
the  blood  and  tissues  be  deficient  in  fluid  this  process 
would  not  go  on,  and  there  would  be  no  purgative 
action.  The  salt  would  be  slowly  absorbed  and  cause 
diuresis,  with  consequent  greater  decrease  in  the  fluid 
of  the  blood.  But  in  cases  of  dropsy  the  fluid  will  be 
drawn  off  and  evacuated  through  the  bowel.  The 
saline  purgatives  should  be  given  in  the  morning,  on 
an  empty  stomach,  in  as  little  water  as  will  dissolve  the 
salt,  the  water  being  as  hot  as  can  be  taken  internally. 
Activity  aids  the  action  of  the  salines,  therefore  the 
person  taking  them  should  move  about  during  the  day 
if  practicable.  The  three  alkalies,  sodium,  potassium, 
and  ammonium,  with  their  salts,  may  be  divided  into 
four  groups. 

I.  In  this  group  are  placed   sodium   chloride  and 
potassium  chloride,  which  exhibit  the  specific  action 
of  the  metallic  ions,  sodium  and  potassium,  and  are 
therefore  depressant. 

II.  Group   two   contains    sodium    and    potassium 
hydroxide,   carbonate,  and  subcarbonate,    which  act 
through  the  non-metallic  ion  (the  hydroxide,  carbonate, 
or  subcarbonate)  by  deoxydizing,  or  drawing  oxygen 
from,  the  tissues.     Their  action  is  manifested  in  three 
ways:  They 

1.  Neutralize  acids,  stop  stomach  secretion,  aid  pan- 
creatic secretion,  and  cause  alkaline  urine.    Some  claim 
that  they  stimulate  stomach  secretion  by  neutralizing 
acid. 

2.  Dissolve  proteids,  and  change  them  to  alkali  pro- 
teids — surface  effect  on  skin  and  mucous  membrane. 

3.  Saponify  fats — surface  of  body  and  alimentary 
canal. 

III.  Ammonium  chloride  represents  this  group.     Its 
action  is  due  to  both  the  metallic  and  non-metallic  ion. 
It  is  stimulant  and  is  used  as  an  expectorant. 


THE  ALKALIES  AND  ALKALINE  EARTHS.   43 

IV.  Ammonium  hydroxide  and  carbonate  belong  to 
this  group,  which  is  noted  for  its  instability.  Am- 
monia is  given  off  freely  and  readily,  exhibiting  its 
stimulant  effect.  "Smelling  salts"  and  aromatic 
spirits  of  ammonia  belong  here. 

Salt  action  is  not  confined  to  the  alkalies  and  salts, 
but  is  possessed  by  other  bodies,  such  as  sugar  and 
urea. 

Potassii     Hydroxidum,    Potassium    Hydroxide. 
(Potash.) 

There  are  three  great  natural  sources  from  which 
potash  and  its  salts  are  derived,  viz.:  i.  W°°cl  ashes. 
2.  Argol,  the  deposit  left  in  wine  casks  during  the  fer- 
mentation of  grape-juice.  3.  Beds  of  saline  earths, 
found  chiefly  in  India,  but  also  to  some  extent  in  other 
countries. 

Physiological  Actions. 

Potash  depresses  the  muscular,  nervous,  and  cardiac 
tissues.  Given  long  or  in  concentrated  doses  it  destroys 
muscle  and  nerve  tissue  and  nerve-centres. 

It  is  extremely  diffusible,  and  is  rapidly  excreted, 
principally  by  the  kidneys,  but  also  to  some  extent  by 
the  salivary,  mammary,  and  intestinal  glands,  and  by 
the  skin. 

In  the  living  organism  it  is  found  chiefly  in  the  blood 
corpuscles  and  muscles. 

Being  so  quickly  removed  from  the  body,  the  danger 
to  the  tissues,  even  from  large  doses,  is  comparatively 
slight,  except  when  there  is  disease  of  the  excretory 
organs,  or  when  it  is  given  for  a  long  time,  and  under 
these  circumstances  a  dyscrasia  or  unhealthy  condition 
results,  characterized  by  impoverishment  and  excessive 
fluidity  of  the  blood. 

Symptoms  of  Poisoning. 

In  poisoning  by  the  salts  of  potash  there  is  violent 
inflammation  of  the  alimentary  canal;  intense  burning 


44  MATERIA  MEDIC  A  FOR  NURSES. 

pain  about  the  epigastrium;  nausea  and  vomiting, 
sometimes  of  bloody  mucus;  and  profuse  and  watery, 
sometimes  dysenteric,  stools.  With  these  there  are  the 
symptoms  of  depression  of  the  general  system:  a  weak, 
rapid  pulse;  shrunken  face;  cold  skin;  coma;  and  in- 
sensibility. There  is  sometimes  paralysis  of  the  lower 
limbs,  and  death  may  occur  with  great  suddenness. 

Treatment  of  Poisoning. 

In  potash  poisoning  dilute  vinegar,  lemon  juice,  and 
cider  are  given  as  antidotes;  the  stomach  and  bowels 
are  emptied,  and  oils,  with  bland  demulcent  drinks, 
such  as  gum  tragacanth,  barley  water,  flaxseed  tea, 
milk,  white  of  egg,  or  gruel,  given  to  relieve  the  irrita- 
tion of  the  mucous  membranes,  and  stimulants  to  sus- 
tain the  heart. 

Preparations  of  Potassium. 

Potassii  Carbonas. 
Potassium  Carbonate. 
Salt  of  Tartar. 

A  white,  granular  powder,  with  strongly  alkaline 
taste  which  liquefies  on  exposure  to  the  air  by  absorb- 
ing moisture  from  it.  Average  dose,  gr.  xv.-i  Gm. 

Potassii  Bicarbonas. 
Potassium  Bicarbonate. 

Sometimes  called  saleratus.  It  is  not  deliquescent  * 
nor  corrosive,  nor  as  irritating  as  the  carbonate;  other- 
wise their  qualities  are  the  same.  They  are  antacid 
stomachics  and  mild  diuretics;  stimulants  of  the 
liver;  expectorants,  and  have  some  slight  diapho- 
retic action. 

In  small  doses  on  an  empty  stomach  they  promote 
the  formation  of  gastric  juice  by  increasing  the  diffusion 
of  the  blood  constituents  from  which  the  gastric  juice 
is  formed.  Large  doses  irritate  the  stomach,  and,  taken 
during  digestion,  decompose  the  gastric  j  uice. 

1  Melting  by  absorbing  moisture  from  the  air. 


THE  ALKALIES  AND  ALKALINE  EARTHS.       45 

These  salts  are  given  before  or  after  meals  according 
to  the  effect  desired.  The  alkalinizing  action  on  the 
stomach  and  kidneys  is  more  pronounced  when  they 
are  taken  during  digestion.  They  must  be  well  diluted, 
in  mucilaginous  or  sweetened  water.  Average  dose, 
gr.  xv.-i  Gm. 

Liquor  Potassii  Hydroxidi. 
Solution  of  Potassium  Hydroxide. 

A  clear,  colorless  liquid,  strongly  alkaline,  contain- 
ing about  six  per  cent,  potassium  hydroxide.  Average 
dose,  irxv.-i  mil,  well  diluted. 


Potassii  Hydroxidum. 
Potassium  Hydroxide. 
Caustic  Potash. 

Grayish-  white  pencils,  hard  but  very  deliquescent. 

Caustic  potash  is  very  powerfully  corrosive.  When 
applied  to  the  skin  it  melts  slowly,  destroying  the 
tissues  by  its  affinity  for  moisture  and  power  of  dis- 
solving albumin.  Its  application  is  very  painful  and 
great  care  is  required  to  avoid  injury  to  the  surround- 
ing tissues.  It  differs  from  nitrate  of  silver  in  extending 
its  action  far  below  the  surface;  for  this  reason  it  is 
used  in  cases  which  require  deep-reaching  action.  The 
healing  process  takes  place  more  slowly  after  the  ap- 
plication of  caustic  potash  than  after  that  of  any  other 
escharotic  in  use.  A  grayish  slough  is  formed,  with 
inflammation  of  the  parts  near  by.  The  slough  re- 
mains for  a  time  varying  from  six  to  twelve  days, 
when  it  separates,  leaving  a  rather  indolent  ulcerated 
surface. 

In  using  caustic  potash  the  surrounding  tissues 
should  be  protected  by  adhesive  plaster,  having  a 
hole  cut  in  it  the  size  of  the  spot  to  be  cauterized. 
The  surface  of  the  plaster  is  oiled,  but  the  oil  must 
not  touch  the  skin.  After  sufficient  action  has  been 


46  MATERIA  MEDICA  FOR  NURSES. 

obtained,  and  the  plaster  removed,  the  spot  may  be 
washed  with  dilute  vinegar. 

In  cases  of  poisoning  by  caustic  potash,  the  corrosive 
action  is  seen  about  the  lips  and  fauces  in  bloody  ooz- 
ing, sloughs  of  mucous  membrane,  and  vomiting  of 
shreds  of  sloughing  and  bloody  tissue.  Deformity  of 
the  mouth  and  contraction  of  the  oesophagus  and  of  the 
cardiac  and  pyloric  orifices  may  remain  after  recovery, 
interfering  mechanically  with  nutrition,  and  resulting 
in  death  after  periods  of  time  varying  from  six  weeks 
to  one  or  two  years. 

Potassii  Citras. 
Potassium  Citrate. 

Made  with  citric  acid  and  potassium  carbonate.  The 
least  unpleasant  of  all  the  preparations  of  potash  except 
the  tartrates.  It  has  diuretic  and  refrigerant  dia- 
phoretic action.  In  the  blood  it  is  decomposed,  and  is 
excreted  by  the  urine  in  the  form  of  alkaline  carbonate. 
Average  dose,  gr.  xv.-i  Gtn.,  well  diluted. 

Potassii  Acetas. 
Potassium  Acetate. 

It  is  antacid,  strongly  diuretic,  and,  in  large  doses, 
mildly  cathartic.  It  increases  the  flow  of  urine  and 
diminishes  the  secretion  of  urea  and  uric  acid.  Average 
dose,  gr.  xv.-i  Gm.,  largely  diluted. 

Potassii  Chloras. 
Potassium  Chlorate. 

The  powder  is  white,  odorless,  with  a  cool,  salty 
taste.  It  is  not  deliquescent.  In  combination  with 
organic  matters  it  is  explosive.  Soluble  in  16  parts  of 
cold  and  2^  parts  of  boiling  water. 

Physiological  Action. 
Potassium  chlorate  acts  as  a  stimulant  to  mucous 


THE  ALKALIES  AND  ALKALINE  EARTHS.       47 

membranes  and  ulcerated  surfaces,  and  its  use  as  an 
application  for  sore  throat  is  familiar.  In  medicinal 
doses  it  has  no  marked  effect  upon  the  system,  but 
taken  continuously  it  is  very  irritating  to  the  kidneys, 
and  causes  chronic  nephritis  or  inflammation  of  those 
organs. 

Poisoning  by  potassium  chlorate  is  manifested  in 
three  directions: 

1.  By   the   formation    of  methaemoglobin   and    the 
destruction  of  red  blood  cells. 

2.  By  irritation  of  the  kidneys. 

3.  By  depression  of  the  heart. 

Minute  quantities  of  the  drug  may  cause  no  ill  effect, 
but  in  children,  or  when  more  of  the  drug  is  taken 
than  nature  can  care  for,  the  formation  of  methsemo- 
globin  by  oxidation  from  the  haemoglobin  of  the  red 
blood  cells  occurs  at  the  same  time  that  the  cells  are 
destroyed.  Extrusion  of  the  haemoglobin  from  the 
cells  is  called  "  laking  "  the  blood.  The  result  of  this 
process  is  that  the  blood  carries  less  oxygen  and  the  tis- 
sues become  asphyxiated  by  lack  of  oxygen,  the  latter 
being  held  in  closer  combination  in  methaemoglobin 
than  in  haemoglobin. 

The  kidneys  are  blocked  up  by  the  detritus  of 
broken-down  cells,  and  there  may  be  acute  inflammation 
of  these  organs — nephritis. 

The  depression  of  the  heart  and  nervous  system  with 
the  body  muscles  is  due  to  the  action  of  the  potassium. 
The  drug  is  especially  dangerous  for  children  and 
should  not  be  given  to  them  as  a  gargle  or  mouth  wash 
in  sore  throat,  diphtheria,  etc. 

The  poisonous  effect  of  potassium  chlorate  is  not  very 
generally  known  among  non-professional  people,  and 
potassium  chlorate  is  used  to  excess  by  numbers  of 
persons,  without  the  authority  of  a  physician,  under 
the  impression  that  it  is  perfectly  harmless.  A  nurse 
has  many  opportunities  of  observing  habits  of  this  kind, 
and  should  use  all  her  influence  to  discourage  them. 
Potassium  chlorate  is  eliminated  unchanged  by  the 
urine. 


48  MATERIA  MEDIC  A  FOR  NURSES. 

Symptoms  of  Poisoning1. 

Taken  in  sufficient  quantities  potassium  chlorate  is  a 
powerful  poison  and  has  often  caused  death.  The 
symptoms  may  be  acute  or  subacute.  In  the  former 
case  there  are  violent  vomiting,  profuse  diarrhoea,  and 
great  dyspnoea  and  cyanosis.  After  death,  which  occurs 
from  heart  failure,  the  blood  is  of  a  chocolate  color.  In 
subacute  cases  there  are  severe  gastro-intestinal  symp- 
toms; vomiting  of  blackish-green  matters  and  swelling 
of  the  liver  and  spleen.  The  urine  is  albuminous, 
diminished,  and  sometimes  suppressed.  Its  color  is 
dark,  reddish  brown,  or  black,  and  under  the  micro- 
scope the  detritus  of  red  blood  corpuscles,  which  had 
choked  the  tubules  of  the  kidney,  may  be  seen.  The 
nervous  symptoms  are  headache,  loss  of  appetite,  great 
pains  in  the  abdomen  and  other  parts  of  the  body, 
marked  abdominal  tenderness,  tonic  and  clonic  muscu- 
lar contractions,  a  peculiar  stiffness  of  the  extremities, 
delirium,  and  coma.  Small  ecchymoses  sometimes 
appear  on  the  surface  of  the  body,  and  there  is  fre- 
quently a  general  jaundice.  In  some  cases  there  is  a 
fatal  relapse  after  the  patient  seems  in  a  fair  way  to 
recover.  The  smallest  poisonous  dose  is  not  known, 
but  in  one  case  death  was  caused  by  a  little  over  §  ss. 
A  child  one  year  old  died  from  3  i.  given  in  a  night, 
and  a  child  of  three  years  from  3  iii.  In  one  case 
death  took  place  a  week  after  taking  |  i. 

Dose,  gr.  iv.-o.25  Gm.,  well  diluted. 

Potassii  Cyanidum. 
Potassium  Cyanide. 

It  has  the  odor  of  hydrocyanic  acid  and  similar 
though  somewhat  alkaline  taste.  It  is  soluble  in  water. 
When  taken  into  the  stomach  the  acids  there  convert 
it  into  hydrocyanic  acid. 

Physiological  Actions. 

The  physiological,  therapeutic,  and  toxic  effects  of 
this  salt  are  like  those  of  hydrocyanic  acid.  Deathv 


THE  ALKALIES  AND  ALKALINE  EARTHS.       49 

however,  does  not  occur  so  soon,  and  insensibility  is 
sometimes  not  manifested  for  several  minutes.  Cases 
of  poisoning  have  occurred  from  inhalation  of  the 
vapor;  also  from  absorption  through  the  hands,  among 
photographers.  There  is,  usually,  little  time  to  employ 
treatment.  A  weak  solution  of  sulphate  of  iron  has 
the  effect  of  decomposing  the  poison,  and  converts  it 
into  Prussian  blue.  Cold  affusions  and  other  treat- 
ment, the  same  as  used  for  hydrocyanic-acid  poisoning, 
may  be  tried.  Death  has  been  caused  by  gr.  v. 

A  solution  of  potassium  cyanide,  in  the  strength  of 
2  to  4  grains  in  f  i.  of  water,  will  remove  the  stains 
of  nitrate  of  silver. 

Potassii  Bitartras. 
Potassium  Bitartrate. 
Cream  of  Tartar. 

Made  from  argol,  and  from  lees  of  wine  by  purifica- 
tion and  evaporation.  White  crystalline  masses  of 
pleasant  acid  taste,  not  readily  soluble  in  water,  requir- 
ing for  solution  in  cold  water  about  180  parts,  or  more. 
An  active  diuretic  and  hydragogue  cathartic.  It  is 
agreeably  given  as  "  cream  of  tartar  lemonade."  The 
quantity  ordered  is  dissolved  in  hot  water,  and  when 
cool,  the  clear  solution  is  poured  off,  flavored  with 
lemon  juice,  and  sweetened  to  taste.  In  excessive 
doses  it  will  produce  gastro-intestinal  troubles,  and  one 
case  of  poisoning  is  recorded  after  taking  over  |  ss. 

Potassii  Nitras. 
Potassium  Nitrate. 
Saltpetre. 

Obtained  for  medicinal  iise  chiefly  by  purification  of 
native  nitre  found  in  beds  of  saline  earths  in  India.  It 
is  also  found  in  saltpetre  caves  in  the  United  States, 
and  is  manufactured  artificially  in  nitre  beds  formed 
of  animal  and  vegetable  matter,  wood  ashes,  and  cal- 
careous earth;  and,  finally,  is  obtained  from  old  plaster 
rubbish. 


50  MATERIA  MEDICA  FOR  NURSES. 

Nitre  is  refrigerant,  diaphoretic,  diuretic,  and  in 
large  doses  laxative.  In  excessive  or  concentrated 
doses  it  may  act  as  a  fatal  poison,  producing  gastro- 
enteritis and  derangement  of  the  nervous  system. 

Symptoms  of  Poisoning. 

Burning  pain  in  throat  and  stomach;  bloody  stools; 
syncope;  collapse  and  death,  sometimes  preceded  by 
convulsions.  Death  has  been  caused  by  §  i.,  but  when 
in  weak  solution  much  larger  quantities  may  be  safely 
taken  taan  would  cause  death  if  concentrated.  There 
is  rio  known  antidote.  Mucilaginous  drinks  should  be 
given,  vomiting  freely  promoted,  and  the  stomach-pump 
used. 

Average  dose,  gr.  viii.-o-5  Gm.,  well  diluted  with 
barley  water  or  other  demulcent. 

Potassii  et  Sodii  Tartras. 
Potassium  and  Sodium  Tartrate. 
Rochelle  Salt. 

Made  by  adding  carbonate  of  soda  to  a  solution  of 
potassium  bitartrate.  A  mild  saline  purgative,  less 
efficient  but  less  offensive  to  the  taste  than  Epsom  salt. 
It  is  given  very  hot  or  very  cold,  in  a  saturated  solu- 
tion. If  given  in  hot  water,  the  addition  of  tr.  ginger, 
gtt.  x.-xv.,  makes  it  more  agreeable  to  the  taste.  If 
cold,  it  may  be  given  in  seltzer  or  carbonated  water. 
It  should  be  given  early  in  the  day  and  on  an  empty 
stomach. 

Average  dose,  3  iiw.-io  Gm. 

Sodium  (Soda). 

There  are  four  natural  sources  of  the  official  salts  of 
soda  and  their  preparations,  viz. : 

1.  Sodium,  a  metallic  element. 

2.  Sodium  chloride,  or  common  salt,  obtained  from 
sea- water  by  evaporation  and  from  salt  mines. 


THE  ALKALIES  AND  ALKALINE  EARTHS.   51 

3.  Sodium  nitrate.     Found  native  in  Chili  and  puri- 
fied by  crystallization  from  water. 

4.  Sodium  borate  or  borax;  a  native  product  found 
in  various  localities. 

Physiological  Actions. 

The  salts  of  soda  are  absorbed  into  the  blood  and 
excreted  from  it  more  slowly  than  the  salts  of  potash, 
and  for  this  reason  the  action  of  soda  upon  the  alimen- 
tary canal  is  stronger  than  that  of  potash.  It  is 
diuretic,  but  not  as  strongly  so  as  potash;  antacid, 
and  purgative.  It  is  less  depressing  than  potash  and 
more  easily  borne  by  the  stomach.  The  soda  salts  are 
taken  into  the  organism  in  large  quantities  with  food, 
especially  vegetables  and  fruits,  and  are  the  chief 
source  of  the  natural  alkalinity  of  the  blood.  Soda  is 
excreted  by  all  the  mucous  surfaces,  by  the  kidneys, 
the  liver,  and,  possibly,  by  the  skin. 

Sodii  Chloridum. 
Sodium  Chloride. 
(Common  Salt.) 

Salt  performs  a  very  important  part  in  the  human 
economy.  It  exists  normally  in  the  blood  in  the  pro- 
portion of  9  to  looo,  and  is  very  abundant  in  various 
normal  secretions.  Active  tissue  changes  are  promoted 
by  the  presence  of  salt.  It  stimulates  the  desire  for 
food,  and  aids  in  its  thorough  alteration  and  absorp- 
tion. It  is  the  natural  antiseptic  of  the  blood;  aids 
osmosis,1  and  keeps  the  fibrin  and  albumin  of  the  blood 
in  solution.  Water  alone  is  injurious  to  cut  tissues, 
but  a  weak  solution  of  salt  makes  it  non-irritant. 
During  the  course  of  an  inflammation  sodium  chloride, 
being  needed  for  its  solvent  action,  accumulates  in  the 
inflamed  area,  disappearing  temporarily  from  the  urine. 
This  is  notably  the  case  in  pneumonia,  and  the  return 
of  the  chloride  to  the  urine  marks  a  favorable  change 

tThe  force  by  which  fluids  pass  through  moist  membranes. 


52  MATERIA  MEDICA  FOR  NURSES. 

in  the  condition  of  the  patient.  In  substance  or  in 
strong  solution  it  is  irritating  to  cut  surfaces,  mucous 
membranes,  muscle  and  nerve  tissue.  Taken  into  the 
stomach  in  large  quantities  it  causes  vomiting,  and 
when  absorbed  in  excess  of  the  needs  of  the  system  it 
causes  the  nervous  irritation  which  produces  the  sensa- 
tion of  thirst,  and  which  is  relieved  by  taking  enough 
water  to  dissolve  the  salt  and  carry  it  away  to  be 
excreted  by  the  kidneys.  Salt  dissolves  in  2f  parts  of 
water. 

In  convalescence  patients  often  crave  some  salty 
article  of  food  which,  being  indigestible,  must  be  denied 
them,  but  the  need  of  the  system  which  is  thus  ex- 
pressed, may  be  satisfied  by  giving  salt  in  another  way. 

The  difficulty  found  by  some  persons  in  digesting 
milk  may  possibly  be  overcome  or  lessened  by  adding 
a  generous  pinch  of  salt  to  the  beverage. 

Salt  water  in  strong  solution  is  an  anthelmintic. 

Sodii  Carbonas. 

Sodium  Carbonate.  Not  official. 

Called  sal  soda,  or  washing  soda.  Transparent  color- 
less crystals,  soluble  in  two  parts  of  water.  Its  effects 
are  similar  to  those  of  the  potassium  carbonate,  but  it  is 
rarely  used  medicinally.  In  large  quantities  it  is  an 
irritant  poison  for  which  oils  and  acids  are  the  anti- 
dotes. It  is  an  excellent  material  for  cleaning  glass, 
china,  and  wood.  Poured  in  strong  solution  into 
drains  and  water-pipes  it  carries  away  grease.  It  will 
remove  the  stains  made  by  bichloride  of  mercury  on 
china  and  glass. 

Sodii  Bicarbonas. 
Sodium  Bicarbonate. 

Soluble  in  12  parts  water  (saturated  solution). 
Sodium  bicarbonate  has  a  soothing  action  in  burns, 
eruptions,  and  irritation  of  the  skin.  Dose,  as  an 
antacid,  gr.  x.-xx.  (0.65-1.3  Gm.)  It  is  pleasantly 
administered  in  carbonated  water — Seltzer  or  Vichy. 


THE  ALKALIES  AND  ALKALINE  EARTHS.        53 

Pulvis  Effervescens  Compositus. 
Compound  Effervescing  Powder. 
Seidlitz  Powder. 

Seidlitz  powder  is  put  up  in  two  packets,  a  white 
paper  containing  gr.  xxv.  of  tartaric  acid  (the  acid  of 
grapes),  and  a  blue  one  containing  gr.  xl.  of  sodium 
bicarbonate  and  gr.  cxx.,  or  3ii.,  of  Rochelle  salt. 
They  are  dissolved  separately  in  very  cold  water,  the 
acid  in  one  or  two  ounces,  and  the  salt  in  five  or  six. 
They  are  then  poured  together  and  taken  after  the 
first  escape  of  gas,  while  still  effervescing.  It  is  hardly 
necessary  to  say  that  they  should  not  be  mixed  at  a 
distance  from  the  patient,  but  at  his  side  and  at  the 
precise  moment  when  he  is  ready  to  take  the  dose. 
The  glass  must  be  large,  to  allow  for  the  effervescence, 
and  it  is  well  to  have  a  saucer  under  it,  to  avoid  the 
annoyance  of  having  it  effervesce  over  the  top  and 
sides.  The  powders  must  be  kept  dry.  Exposed  to 
the  air  they  become  damp  and  lose  their  effervescing 
quality.  Seidlitz  powder  is  refrigerant  and  laxative, 
and  should  be  given  in  the  morning  on  an  empty 
stomach.  One  powder  is  usually  sufficient  for  a  dose, 
acting  in  from  three  to  six  hours. 

Sodii  Boras. 
Sodium  Borate. 
Bcrax. 

Borax  is  found  as  a  native  product  in  several  locali- 
ties. It  is  also  artificially  made  by  combining  native 
boric  acid  with  soda.  On  the  skin  it  acts  as  a  soap — 
removing  the  waste.  Added  to  "hard"  water,  it 
softens  it  pleasantly  for  bathing  purposes,  and  is  useful 
in  many  local  and  external  applications  by  means  of 
its  cleansing  properties. 

Lithium  (Lithia). 

Lithium  is  obtained  from  several  minerals,  and 
traces  of  it  are  found  in  certain  mineral  waters. 

Lithium  salts  have  strong  alkaline  properties,  and 


54  MATERIA   MEDICA    FOR  NURSES. 

act  on  the  human  organism  as  do  the  other  members 
of  the  group.  It  is  stated  that  lithium  salts  alka- 
linize  the  urine  more  decidedly  even  than  salts  of 
potassium. 

Preparations. 

Lithii  Carbonas.    Lithium  Carbonate. 

Average  dose,  gr.  viii.-o.5  Gtn. 
Lithii  Citras.  Lithium  Citrate. 

Average  dose,  gr.  viii.-o.5  Gm. 
Lithii  Bromi  e.  Lithium  Bromide. 

Average  dose,  gr.  xv.-i  Gm. 

Ammonium  (Ammonia). 

Ammonia  is  a  gaseous  compound  of  hydrogen  and 
nitrogen;  colorless,  irrespirable,  highly  irritant,  of 
strong  alkaline  reaction  and  pungent  odor.  It  is  ob- 
tained in  the  manufacture  of  coal  gas,  and  occurs  as  a 
result  of  the  decay  of  organic  substances. 

Physiological  Actions. 

Applied  to  the  skin,  ammonia  is  a  powerful  irritant, 
causing  redness,  blistering,  and  sloughing.  Inhaled, 
it  causes  severe  irritation  of  the  air-passages,  with 
sneezing,  disturbed  respirations,  flow  of  water  from  the 
eyes  and  nose,  and  quickened  pulse.  Ammonia  acts 
as  a  general  stimulant  to  the  heart  and  nervous  sys- 
tem, especially  the  spinal  cord  and  respiratory  centre. 
Being  rapidly  diffused,  its  action  is  prompt  but  some- 
what transitory.  It  is  excreted  by  the  kidneys  and 
mucous  membranes. 

Symptoms  of  Poisoning. 

In  large  amount  ammonia  is  a  corrosive  poison, 
producing  violent  abdominal  pain,  vomiting  and  purg- 
ing of  bloody  matters,  with  convulsions,  collapse,  and 
death.  Consciousness  may  remain  until  the  last,  or 
coma  may  precede  death.  In  some  cases  death  has 


THE  ALKALIES  AND  ALKALINE  EARTHS.   55 

taken  place  within  five  minutes,  having  been  caused 
probably  by  oedema  of  the  larynx.  The  symptoms 
come  on  at  once  in  poisoning  by  ammonia. 

Treatment  of  Poisoning. 

Dilute  vinegar  or  lemon  juice  is  given  to  counteract 
the  alkali;  oils  and  bland  liquids  to  soothe  the  mucous 
membrane,  which  is  corroded.  Heat  favors  the  action 
of  ammonia,  and  cold  antagonizes  it;  therefore,  in 
poisoning  by  ammonia  plenty  of  cold  fresh  air  should 
be  admitted,  if  possible,  and  cold  applications  made 
to  the  head.  The  feet  must  be  kept  warm. 

Preparations  of  Ammonia. 

Ammonii  Chloridum. 
Ammonium  Chloride. 

A  white  crystalline  or  granular  powder,  of  a  cooling, 
salty  taste.  The  action  of  ammonium  chloride  on  the 
skin  is  soothing  rather  than  irritating,  as  applied  in 
lotions.  It  has  a  cooling  effect,  and  is  a  tonic  to  the 
sensory  nerves,  and  reduces  local  external  inflammation. 
It  has  a  stimulant  action  on  the  liver;  is  diuretic 
and  diaphoretic,  and,  like  other  preparations  of  am- 
monia, a  stimulant  expectorant.  The  taste  is  very 
nauseous,  resembling  sea-water. 

Average  dose,  gr.  v.-o-3  Gm.,  well  diluted  with  cold 
water. 

Ammonii  Carbonas. 
Ammonium  Carbonate. 

A  very  active  and  quickly  diffusible  stimulant  to 
the  heart  and  respiration,  and  an  expectorant,  acting 
in  the  latter  capacity  by  liquefying  the  bronchial  secre- 
tions, which  are  thus  more  easily  raised,  and  the  air- 
cells  kept  free.  In  large  doses  (gr.  xxx.)  ammonium 
narbonate  acts  as  an  emetic.  It  has  a  nauseous  taste, 


56  MATERIA  MEDICA  FOR  NURSES. 

is  very  pungent,  and  must  be  well  diluted.     It  may  be 
given  in  milk. 

Average  dose,  gr.  v.-o.3  Gm. 

Aqua  Ammoniac  Portion 
Stronger  Ammonia  Water. 

Has  a  strength  of  28  per  cent.,  and  has  been  used  as 
an  application  to  the  bites  of  poisonous  animals  or  ser- 
pents. It  may  be  used  as  a  vesicant,  but  its  action  is 
apt  to  be  more  severe  than  is  desirable.  It  acts  more 
quickly  than  cantharides,  and  does  not  affect  the  urinary 
organs. 

Aqua  Ammonias. 
Ammonia  Water. 

A  solution  of  the  gas  in  water,  10  per  cent,  in  strength. 
It  may  be  used  externally  as  a  counter-irritant.  Ap- 
plied in  dilute  solution  to  the  bites  made  by  insects,  it 
relieves  the  sting.  Taken  internally,  it  is  a  general 
stimulant  and  antacid. 

Average  dose,  TU  xv.-i  mil,  largely  diluted. 

Spiritns  Ammonias  Aromaticus. 
Aromatic  Spirit  of  Ammonia. 

Contains  ammonia  water,  and  ammonium  carbonate, 
with  oil  of  nutmeg,  of  lemon,  and  of  lavender;  alcohol 
and  water.  It  is  an  antacid  and  stomachic,  overcoming 
a  feeling  of  nausea,  and  a  general  stimulant.  It  is  not 
unpleasant. 

Average  dose,  ~n\,  xxx.-2  mils,  "well  diluted  in  milk 
or  water. 

Liquor  Ammonii  Acetatis. 
Solution  of  Ammonium  Acetate. 
Spirit  of  Mindererus. 

Made  from  carbonate  of  ammonia  ,and  diluted  acetic 
acid.  It  is  more  active  than  the  other  preparations,  as 


THE  ALKALIES  AND  ALKALINE  EARTHS.       57 

a  diaphoretic,  especially  if  the  body  be  kept  warm. 
If  the  skin  be  kept  cool,  its  diuretic  action  is  more 
pronounced.  It  must  be  freshly  prepared.  Average 
dose,  3  iv.-i5  mils,  well  diluted  with  water. 

Linimentum  Ammonias. 

Ammonia  Liniment.     Hartshorn  Liniment. 

A  mixture  of  ammonia  water  with  sesame  oil.  It 
should  be  freshly  made. 

RaspaiPs  Sedative  Water.   Not  official. 

A  mixture  of  ammonia  water,  sodium  chloride,  and 
camphorated  spirits  of  wine,  with  water.  For  sponge 
baths;  cooling  and  sedative. 

Nitrous  Oxide  Gas  (Laughing  Gas). 

Nitrous  oxide  gas  is  a  colorless,  inodorous  gas  that 
can  be  liquefied  by  pressure,  and  is  made  by  heating 
ammonium  nitrate  to  350-450°  F. ,  and  washing  the  gas. 
It  is  used  in  dentistry,  in  minor  surgery,  and  as  a 
starter  in  ether  and  chloroform  anaesthesia.  It  is  ad- 
ministered through  an  inhaler  connected  with  a  cylin- 
der, where  the  gas  is  under  pressure,  and  is  given 
without  admixture  with  air.  The  inhalation  is  carried 
on  until  distinct  cyanosis  is  visible.  Unconsciousness 
comes  on  in  from  one-half  to  three  minutes.  Anaes- 
thesia occurs  when  the  blood  becomes  dark.  Blood 
pressure  is  very  high  and  there  is  almost  complete 
asphyxia.  Return  to  consciousness  occurs  in  from  one 
to  three  minutes  after  removal  of  the  gas,  without 
leaving  any  after-effects  except  a  slight  headache, 
which  may  persist  for  hours.  Nitrous  oxide  is  the 
safest  known  anaesthetic,  and  much  the  most  pleasant. 

Calx.  Calcium  Oxide,  Lime, 

Calcium  occurs  abundantly  in  nature  and  in  manu- 
facture. It  is  found  largely  as  a  carbonate  in  the  form 
of  limestone,  chalk,  marble,  etc.;  as  a  sulphate  as 


58  MATERIA  MEDIC  A  FOR  NURSES. 

plaster  of  Paris,  gypsum,  alabaster;  as  a  phosphate  in 
the  different  phosphate  rocks  and  bone  ash.  Calcium  is 
an  exceedingly  important  constituent  of  the  body, 
being  found,  in  the  form  of  solution  of  the  phosphate, 
in  every  animal  tissue  and  fluid.  It  gives  solidity  to 
bones,  and  accumulates  wherever  rapid  tissue  changes 
are  taking  place.  The  preparations  of  calcium  are 
antacid  and  slightly  astringent.  locally  they  are 
sedative  to  mucous  membrane.  Calcium  is  a  valuable 
antidote  in  poisoning  by  oxalic  acid,  chloride  of  zinc, 
and  the  mineral  acids.  It  can  always  be  obtained  for 
this  purpose  in  the  form  of  wall-plaster  or  whitewash. 

Preparations  of  Calcium  Oxide. 

Calx. 

Lime. 

Made  from  chalk  or  limestone  by  calcining  (purifying 
and  rendering  friable  by  the  action  of  heat).  In  this 
state  it  has  the  form  of  compact  white  masses,  which 
readily  absorb  water,  crack,  evolve  heat,  and  fall  into 
powder.  It  is  then  called  slaked  lime,  or  quick-lime. 
If  it  should  come  in  contact  with  the  eye,  it  should  be 
washed  out  with  a  solution  of  boric  acid. 

Liquor  Calcis.     Solution  of  Calcium  Hydroxide. 
Lime-Water. 

Lime-water  is  a  saturated  solution  of  lime  containing 
about  |  of  a  grain  to  §  i.  of  water.  It  is  made  by 
washing  slaked  lime  and  shaking  it  up  in  distilled 
water,  preferably,  though  ordinary  water  may  be  used. 
After  it  settles,  the  water  is  poured  off  from  the  sedi- 
ment and  strained.  It  is  colorless,  inodorous,  and 
has  a  disagreeable  alkaline  taste.  By  exposure  to  the 
air  it  absorbs  carbonic  acid,  and  should  therefore 
always  be  kept  well  corked.  Lime-water  acts  as  a 
gastric  sedative,  and  added  to  milk  prevents  its 
curdling  in  large  lumps.  The  ordinary  proportion  is 
lime-water  §  ss.  to  milk  f  v.,  increased,  according  to 


THE  ALKALIES  AND  ALKALINE  EARTHS.   59 

circumstances,  to  J  or  even  £  lime-water.     Lime-water 
is  slightly  constipating. 

Milk  of  Lime.     Whitewash.    Not  official. 

To  one  part  of  slaked  lime,  as  above,  four  parts  of 
water  are  added.  This,  mixed  thoroughly  with  in- 
fectious stools,  and  added  until  the  mixture  gives  a 
strong  alkaline  reaction  when  tested  with  litmus  paper, 
is  considered  an  efficient  disinfectant  for  cholera  and 
typhoid  stools.  Next  to  it  in  value  comes  chloride 
of  lime,  which  is  not  effective  unless  fresh.  This  is  to 
be  made  in  a  solution  of  six  ounces  to  one  gallon  of 
water. 

Syrupus  Calcii  Lactophosphatis. 
Syrup  of  Calcium  Lactophosphate. 

Contains  calcium  carbonate,  lactic  acid,  and  phos- 
phoric acid.  Average  dose,  3  iiss.-io  mils. 

Linimentum  Calcis. 
Lime  Liniment. 
Carron  Oil. 

A  mixture  of  lime-water  and  olive  oil  or  linseed  oil, 
in  equal  parts,  for  external  use.  It  is  an  excellent  ap- 
plication for  burns,  and  has  the  merit  of  cheapness. 

Creta  Praeparata. 
Prepared  Chalk. 

Made  from  chalk  by  a  cleansing  and  drying  process. 
A  smooth  white  powder,  insoluble  in  water,  and  of 
astringent  action.  Externally,  it  is  used  as  a  dusting- 
powder.  When  taken  internally  it  may  be  administered 
in  glycerin  or  syrup.  Average  dose,  gr.  xv.-i  Gm. 

Mistura  Cretae. 
Chalk  Mixture. 

Contains  prepared  chalk,  and  is  an  astringent.  It 
must  be  freshly  made.  Dose,  %  ss.-i5  mils. 


60  MATERIA  MEDICA  FOR  NURSES. 

Calcii  Chloridura. 
Calcium  Chloride. 

A  white  salt,  very  deliquescent,  and  soluble  in  water. 
Odorless,  with  a  sharp,  salty  taste.  Average  dose, 
gr.  viii.-o.5  Gm. 

Magnesii  Oxidurn,  Magnesium  Oxide, 
Magnesia. 

The  official  preparations  of  magnesia  are  all  derived, 
directly  or  indirectly,  from  the  sulphate. 

Physiological  Actions. 

Magnesia,  in  the  form  of  the  oxide  and  carbonates, 
forms  insoluble  and  comparatively  harmless  compounds 
with  the  mineral  acids.  It  is  therefore  used  as  an  anti- 
dote for  these  poisons,  the  oxide  being  preferable,  and 
to  be  very  freely  given. 

Magnesia  has  antacid,  purgative,  and  diuretic 
qualities.  Kntering  the  circulation,  it  increases  the 
alkalinity  of  the  plasma,  and  is  partly  excreted  by  the 
kidneys,  rendering  the  urine  more  abundant  and  less 
acid. 

Preparations  of  Magnesia. 

Magnesii  Sulphas. 
Magnesium  Sulphate. 
Epsom  Salt. 

Made  from  dolomite,  or  magnesian  limestone,  by 
solution  in  sulphuric  acid  and  purification.  A  quickly 
acting  hydragogue  cathartic,  easily  borne  by  the 
stomach,  though  of  nauseous  taste.  Ordinary  laxative 
doses  act  in  a  few  hours.  Large  doses  (  §  i.-ii.)  produce 
a  result  almost  immediately,  and  cause  griping  and 
abdominal  distension.  It  should  be  given  well  diluted 
and  on  an  empty  stomach.  It  is  soluble  in  2j  parts  of 
water.  Dose,  §  ss.  (15  Gm.)  in  carbonated,  Seltzer, 
or  Vichy  water. 


THE  METALS.  6l 

Liquor  Magneszi  Citratis. 
Solution  of  Magnesium  Citrate. 

In  small  doses  a  laxative,  in  large  ones  cathartic, 
acting  in  from  four  to  six  hours.  It  is  effervescent, 
and  should  be  kept  cold  and  taken  at  the  moment  it  is 
poured  out.  If  the  whole  amount  is  not  taken  at  once 
the  bottle  should  be  stood  on  the  corked  end  or  laid  on 
its  side.  Average  dose,  §  xii.-350  mils. 

Magnesii  Sulphas  Effervescens. 
Effervescent  Magnesium  Sulphate. 

A  white  coarse-grained  salt  of  refreshing  taste,  very 
soluble  and  effervescent,  acting  in  the  same  way  as  the 
liquor. 

Dose,  3  i.-iv.  stirred  up  in  cold  water.    (4-15  Gm.) 

Cerium  (Cerium). 
A  metal  of  which  the  oxalate  only  is  used. 

Cerii  Oxalas. 
Cerium  Oxalate. 

A  white  granular  powder,  insoluble  in  water,  alcohol, 
or  ether.  It  is  a  gastric  sedative,  and  is  given  dry 
on  the  tongue.  Average  dose,  gr.  iii.-o.2  Gm. 

THE  METALS. 
Plumbum  (Lead). 

Lead  is  found  native  in  small  masses.  It  is  a  dull, 
whitish  metal  with  a  tint  of  blue,  and  is  not  given  in  its 
native  state,  medicinally,  but  in  the  form  of  salts. 

Physiological  Actions. 

The  special  property  of  the  lead  salts  is  astringency, 
and  they  are,  in  consequence,  sedative,  anti-phlogis- 
tic, and  haemostatic. 


62  UATERIA  MEDICA  FOR  NURSES. 

Used  in  dilute  solutions  externally  as  applications  to 
ulcers,  mucous  surfaces,  etc.,  they  precipitate  the  albu- 
minous fluids  which  cover  the  surface,  contract  the 
small  blood-vessels,  and  harden  the  tissues  of  the  young 
growing  cells.  Applied  in  concentrated  solutions, 
they  are  irritant,  causing  inflammation,  or  increas- 
ing it.  Taken  internally,  their  action  is  first  evident 
as  a  peculiar  astringent  taste,  with  a  dry  feeling  of  the 
throat.  In  the  stomach  and  intestines  the  same  action 
is  shown.  Lead  dries  the  secretions,  contracts  the 
vessels,  and  checks  peristaltic  action,  thus  causing 
constipation. 

It  is  changed  by  the  intestinal  juices  into  an  albumi- 
nate,  and  so  enters  the  blood.  It  is  rapidly  deposited 
in  the  tissues,  especially  in  the  central  nervous  system, 
the  kidneys,  liver,  and  bones.  It  is  excreted,  but 
slowly,  in  the  bile,  the  urine,  and  perspiration;  also  by 
the  mammary  glands.  It  diminishes  the  excretion  of 
uric  acid  by  the  kidneys. 

Poisoning-  by  Lead. 

Acute  lead  poisoning  is  rare,  and  will  be  spoken  of 
in  connection  with  the  acetate.  Chronic  poisoning  is 
quite  common,  the  poison  being  introduced  into  the 
system  in  one  or  more  of  the  following  ways:  By  ab- 
sorption through  the  unbroken  skin,  as  in  the  case  of 
painters,  glaziers,  etc. — the  fine  particles  of  metal  which 
are  rubbed  off  and  adhere  to  the  skin  being  changed  by 
its  secretions  into  soluble  salts  which  are  readily  ab- 
sorbed; by  absorption  through  ulcers,  wounds,  etc., 
from  the  excessive  application  of  ointments;  by  the  use 
of  food  put  up  in  cans  soldered  with  lead,  cooking 
utensils  made  of  painted  wood  or  imperfectly  burnt 
pottery,  and  by  eating  buns,  cake,  etc.,  colored  with 
chromate  of  lead;  by  the  habit  of  biting  silk  thread 
adulterated  with  lead;  by  sleeping  or  working  in 
newly  painted  rooms,  and  by  the  poisoning  of  a  water 
supply  from  lead  pipes.  This  does  not  occur  with 
"  hard ' '  water — viz.,  that  containing  salts  of  lime,  as  an 


THE  METALS.  63 

insoluble  coating  is  then  deposited  on  the  lining  of  the 
pipes;  but  with  pure,  or  "soft"  water,  the  lead  is 
slowly  dissolved  in  the  form  of  a  carbonate.  The  first 
symptoms  of  poisoning  are:  A  feeling  of  pain,  with  a 
sense  of  sinking  in  the  region  of  the  navel;  loss  of  ap- 
petite, thirst,  and  dryness  of  the  mouth  and  throat, 
with  a  metallic  astringent  taste;  pale  face  and  skin 
generally;  fetor  of  the  breath;  constipation:  emaciation 
and  wasting  of  the  muscles,  especially  those  of  the 
arms;  swelling  of  the  joints,  and  rheumatic  pains. 
Colic  is  a  very  pronounced  symptom,  sometimes  com- 
ing on  very  suddenly,  sometimes  after  several  days' 
illness.  The  pain  is  intense  and  varies  in  character, 
sometimes  being  sharp,  sometimes  dull,  or,  again, 
"  twisting,"  and  seems  to  centre  about  the  umbilicus. 
This  fact  of  its  being  localized  differentiates  it  from 
hepatic  colic,  which  goes  through  to  the  back,  and 
from  renal  colic,  which  radiates  along  the  line  of  the 
ureters.  The  abdominal  walls  are  violently  retracted 
and  rigid,  and  neuralgic  pains  seize  the  abdominal 
muscles  and  shoot  along  those  of  the  thorax  and  ex- 
tremities, especially  the  flexors.  The  skin  and  con- 
junctivae  sometimes  become  jaundiced,  and  the  urine 
tinged  with  bile. 

A  very  striking  feature  of  lead  poisoning,  occurring 
both  in  acute  and  chronic  cases,  is  the  dark  slate- 
coi^red  line  on  the  gums  along  the  margin  of  the  in- 
cisor teeth.  It  is  said  to  be  more  marked  in  those 
cases  where  the  tooth-brush  is  not  used. 

The  chronic  nervous  symptoms  of  lead  poisoning 
may  be  developed  after  the  first  attack  of  colic,  or  they 
may  come  on  without  marked  abdominal  disturbance. 
The  most  common  and  noticeable  one  is  the  paralysis 
of  the  extensor  muscles  of  the  forearms,  causing  what 
is  termed  "  wrist-drop."  With  this  there  is  sometimes 
either  partial  or  complete  anaesthesia  of  the  affected 
members. 

Paralysis  of  the  laryngeal  muscles  sometimes  occurs, 
resulting  in  aphonia.  The  pulse  is  incompressible  and 
tense,  full,  and  infrequent.  There  may  be  anaesthesia 


64  MATERIA  MEDICA  FOR  NURSES. 

of  the  optic  nerve  as  a  result  of  the  direct  action 
of  lead,  or  dimness  of  sight  may  result  from  the  albu- 
minuria  which  is  often  present;  and,  finally,  there 
may  be  a  condition  of  cerebral  disturbance  known  as 
"  encephalopathia  saturnina,"  or  lead  encephalopathy, 
beginning  with  headache,  and  characterized  by  de- 
lirium, stupor,  epileptiform  convulsions,  and  coma. 
Death  may  follow,  although  severe  cases  have  been 
known  to  recover.  Death  may  also  result  from  the 
gradual  failure  of  nutrition,  or  from  an  extension  of 
paralysis  to  the  muscles  of  respiration. 

Treatment  of  Poisoning. 

In  treating  chronic  lead  poisoning,  large  doses  of 
purgatives  are  given.  Potassium  iodide  aids  in  elimi- 
nation of  the  poison,  and  baths  of  potassium  sulphide 
are  also  used  for  this  purpose.  Workers  in  lead  may 
guard  against  poisoning  by  personal  cleanliness,  which 
is  of  great  importance,  by  the  use  of  sulphuric-acid 
lemonade,  and  milk,  as  a  food,  in  large  quantities. 

Preparations  of  Lead. 

Plumb!  Acetas. 
Lead  Acetate. 
Sugar  of  Lead. 

Made  by  the  action  of  acetic  acid  on  litharge,  or 
lead  oxide.  This  is  the  only  preparation  of  lead  given 
internally.  Acute  poisoning  has  been  caused  by  the 
lead  acetate,  although,  as  it  acts  as  an  emetic,  it  is 
rarely  fatal.  The  symptoms  appear  in  from  half  an 
hour  to  two  hours  after  taking  it,  and  are  essentially 
the  same  as  described  under  chronic  poisoning.  Re- 
covery may  take  place  within  a  few  days,  although 
symptoms  recur,  occasionally,  after  a  long  interval. 
The  fatal  dose  is  between  f  i.  and  |  ii.  The  treatment 
consists  of  large  doses  of  Glauber's  and  Epsom  salts; 
castor  oil;  emetics,  if  vomiting  is  not  already  excited; 
opium;  and  albuminous  drinks  freely  given. 

Average  dose,  gr.  i.-o.o6  Gm. 


THE  METALS.  65 

Liquor  Plumbi  Subacetatis. 
Solution  of  Lead  Subacetate. 
Goulard's  Extract. 

Used  only  externally.  It  should  be  diluted,  in  a 
strength  of  §  i.-iv.  to  O.  i.  of  water. 

Ceratum  Plumbi  Subacetatis. 
Cerate  of  Lead  Subacetate. 
(Goulard's  Cerate.) 

Compound  of  wool  fat,  paraffin,  white  petrolatum, 
camphor,  and  Goulard's  extract.  For  external  use. 

Emplastrum  Plumbi. 
Lead  Plaster. 
Diachylon  Plaster. 

Made  with  lead  oxide,  oil,  lard,  and  water. 

Emplastrum  Adhaesivum. 
Adhesive  Plaster. 

Made  of  rubber,  lead  plaster,  and  petrolatum. 

Emplastrum  Saponis. 
Soap  Plaster. 

Made  of  soap,  lead  plaster,  and  water. 

Unguentum  Diachylon. 
Diachylon  Ointment. 

Made  of  lead  plaster,  petrolatum,  and  oil  of  lavender. 
Argent um  (Silver). 

The  metal  silver  itself  is  not  used  in  medicine,  and 
its  preparations  are  not  numerous.  The  properties  of 
silver  will  be  described  under  its  most  important  salt. 

Argenti  Nitras. 
Silver  Nitrate. 

Prepared  by  dissolving  silver  in  nitric  add.  ; 


66  MATERIA  MEDICA  FOR  NURSES.' 

Physiological  Actions. 

Silver  nitrate  has  locally  a  caustic,  or  corrosive 
action.  It  combines  with  the  albumin  of  the  tissues, 
forming  a  superficial  slough.  It  has  a  strong  metallic 
and  styptic  taste,  and  in  the  stomach  produces  a  feeling 
of  warmth.  It  is  decomposed  by  the  gastric  juice,  and, 
therefore,  does  not  act  as  an  irritant  to  the  stomach, 
unless  taken  in  poisonous  doses.  Silver  enters  the 
blood  as  an  albuminate,  and,  if  continued  for  some 
time,  a  part  of  it  remains  permanently  in  the  connective 
tissues,  staining  them  a  dull  slate-gray,  which  cannot 
be  removed.  This  tinge  first  appears  as  a  line  along 
the  gums  and  teeth,  and  on  the  mucous  membrane  in- 
side the  lips  and  cheeks.  In  small  doses  silver  is 
astringent  and  anti-spasmodic,  stimulates  secre- 
tion and  nutritive  processes,  and  is  a  nerve  tonic. 
Long  continued  it  disorders  digestion,  and  produces  a 
general  waste  of  tissue,  albuminuria,  rapid  and  irregu- 
lar heart  action,  disturbed  respiration,  and  nervous 
symptoms,  viz. :  tetanic  convulsions,  loss  of  the  powet 
of  co-ordination,  and  paralysis. 

Symptoms  of  Poisoning. 

In  toxic  doses  silver  causes  gastro-enteritis,  and  the 
antidote  is  common  salt,  given  very  freely  in  solution. 
It  forms  an  insoluble  chloride,  and  also  acts  as  an 
emetic. 

Preparations  of  Silver. 

Average  dose  of  the  nitrate,  gr.  i-o.oi  Gm.,  in  pill, 
given  after  meals,  unless  otherwise  ordered.  Silver 
nitrate  is  quickly  decomposed,  if  in  solution,  by  organic 
matter  and  by  the  action  of  light,  and  is  for  that  rea- 
son kept  in  dark-colored  bottles,  and  should  never  be 
left  uncorked.  With  tannin  it  forms  an  explosive 
compound. 


THE  METALS.  67 

Argenti  Nitras  Fusus. 
Moulded  Silver  Nitrate. 
Lunar  Caustic. 

Made  by  evaporating  silver  nitrate  and  forming  it 
in  pencil-shaped  moulds.  It  is  used  externally  as  a 
caustic.  It  is  not  deliquescent;  its  action  is  superficial 
and  does  not  extend  beyond  the  point  touched;  and  the 
slough  formed  is  rapidly  healed.  In  applying  silver 
nitrate  the  pencil  should  always  be  washed  in  an  anti- 
septic solution  before  and  after  using,  and,  especially 
before  it  is  put  away,  carefully  dried. 

Argenti  Nitras  Mitigatus. 
Mitigated  Silver  Nitrate. 
(Mitigated  Caustic.) 

Made  with  silver  nitrate  and  potassium  nitrate.  For 
local  use  externally,  and  is  used  as  an  application  to 
the  eyelids. 

Aurum  (Gold). 
Preparations  of  Gold. 

Auri  et  Sodii  Chloridum. 
Gold  and  Sodium  Chloride. 

This  salt  is  a  somewhat  deliquescent  powder  of  salty 
metallic  taste,  soluble  in  water.  The  precise  physio- 
logical actions  of  the  salts  of  gold  are  not  well  under, 
stood.  Clinically  the  gold  preparations  are  looked 
upon  as  alteratives  and  nerve  tonics,  improving  general 
nutrition,  and  more  especially  the  nutrition  of  the  ner- 
vous system.  The  most  prominent  use  of  gold  is  in 
connection  with  the  alcohol  habit.  It  is  believed  that 
in  the  Keeley  Institutes  for  the  cure  of  alcoholism  the 
treatment  consists  in  part  at  least  of  the  gold  and 
sodium  chloride,  with  intervening  doses  of  strychnine 
and  atropine. 

The  average  dose  in  solution  or  pill  form  is  gr.  -h- 
0.005  Gm.  Hypodermically  it  is  irritating  and  painful. 


68  MATERIA  MEDIC  A  FOR  NURSES. 

Auri  Chloridum.   Not  official. 
Gold  Chloride. 

This  salt  is  not  in  frequent  use.     Dose,  gr« 
(0.00043  Gm.) 

Auri  et  Potassii  Bromidum.    Not  official. 
Gold  and  Potassium  Bromide. 

This  drug  is  usually  given  hypodermically.  Un- 
pleasant symptoms  referable  to  the  cardiac  region  may 
be  caused  by  it,  as  pain  and  rigor,  but  they  do  not  last 
long.  Dose,  gr.  J-f .  (0.02-0.04  Gm.) 

Zincum,  Zinc. 

There  are  two  sources  of  the  salts  and  preparations 
of  zinc,  viz.:  the  metal,  zinc,  and  the  native  carbonate, 
calamine.  Not  official  as  a  metal. 

Physiological  Actions. 

The  salts  of  zinc  are,  in  their  stronger  forms,  caustic  ; 
in  weaker  forms,  astringent  and  antiphlogistic. 
The  activity  of  the  different  preparations  is  in  propor- 
tion to  their  solubility  and  diffusibility.  Applied  to  a 
broken  surface  or  mucous  membrane,  the  salts  of  zinc 
harden  the  albuminous  secretions,  check  the  growth  of 
new  cells,  and  contract  the  vessels,  though  in  a  lesser 
degree  than  do  lead  and  silver.  The  salts  of  zinc,  in 
the  blood,  take  the  form  of  albuminates.  They  enter 
the  circulation  slowly,  do  not  have  the  tendency  to 
accumulate  and  remain  fixed  in  the  tissues  as  do  lead, 
mercury,  and  copper,  and  are  much  more  rapidly  ex- 
creted. They  are  eliminated  by  the  liver,  kidneys, 
intestinal  and  mammary  glands. 

Symptoms  of  Poisoning. 

If  the  use  of  zinc  be  long  continued  there  may  result 
a  series  of  symptoms  similar  to  those  of  lead-poisoning, 
though  less  severe — viz.,  wasting  of  the  tissues  and 


THE  METALS.  69 

loss  of  strength;  pallor;  muscular  weakness  and  trern* 
bling;  colic;  fetid  breath ;  constipation;  feeble  mind; 
and  paralysis. 

Treatment  of  Poisoning. 

In  cases  of  acute  poisoning  by  zinc  salts  the  antidotes 
are  lime-water,  tannin,  in  the  form  of  strong  tea,  car- 
bonate of  sodium  or  potassium,  soap-suds,  and  muci- 
laginous drinks,  milk,  etc.  Vomiting  should  be 
encouraged  and,  if  necessary,  the  stomach  washed  out. 

Preparations  of  Zinc. 

Zinci  Chloridum. 
Zinc  Chloride. 

Made  by  dissolving  zinc  which  has  been  melted  and 
poured  into  cold  water,  in  dilute  hydrochloric  acid,  and 
boiling.  It  then  goes  through  several  purifying  pr  o- 
cesses.  A  whitish-gray,  deliquescent  substance,  soft, 
like  wax,  and  with  very  corrosive  and  irritant  action. 
It  is  used  as  a  caustic  and  acts  powerfully,  causing 
destruction  of  the  part,  with  severe  pain,  followed  by 
sloughing  which  heals  slowly.  An  impure  solution 
known  as  Burnett's  fluid,  containing  200  grains  to  §  i. 
of  water,  is  sold  as  a  disinfectant  and  has  caused  numer- 
ous cases  of  poisoning.  The  symptoms,  whi(h  are 
those  of  severe  gastro-enteritis  and  collapse,  come  on 
immediately,  and  death  may  result  in  a  few  ho  urs,  or 
be  delayed  for  several  days. 

Zinci  Sulphas.1 
Zinc  Sulphate. 

Made  by  dissolving  zinc  in  dilute  sulphuric  add,  and 
crystallizing.  Soluble  in  water.  In  small  doses  sulphate 

1  Zinc  solution  for  the  disinfection  of  white  clothing.  Sul- 
phate of  zinc,  §  ii.  Common  salt,  §  iv.  Water,  i  gallon. 
Soak  clothes  for  from  4  to  6  hours,  boil,  and  wash. 


70  MATERIA  MEDIC  A  FOR  NURSES. 

of  zinc  has  tonic  and  astringent  properties.  Con- 
tinued long  in  medicinal  doses  it  may  cause  ulcera- 
tion  of  the  mucous  membrane  of  the  alimentary  canal. 
Zinc  sulphate  is  a  specific  emetic.  It  acts  promptly, 
and  entirely  by  its  local  irritant  action,  not  being 
absorbed,  and  causing  no  flow  of  secretions.  It  is  not 
constitutionally  depressing,  and  causes  but  little  nausea 
either  before  or  after  the  act  of  vomiting. 

Average  dose  (medicinal),  gr.  rr-o.oo6  Gm. 

Dose  (emetic),  gr.  xv.-i  Gm.,  largely  diluted  with 
warm  water,  and  given  every  fifteen  minutes  until 
vomiting  occurs. 

Zinci  Oxidum. 
Zinc  Oxide. 

A  yellowish  white  powder,  insoluble  in  water,  and 
used  principally  to  dust  over  the  skin  as  an  astringent 


Unguentum  Zinci  Oxidi. 
Ointment  of  Zinc  Oxide. 


Made  of  oxide  of  zinc,  usually  twenty  parts,  to  ben 
zoinated  lard,  eighty  parts. 

Cuprum  (Copper). 

The  action  of  copper  is  very  similar  to  that  of  silver 
and  zinc.  Metallic  copper  is  inert.  The  salts  are  not 
absorbed  by  the  unbroken  skin,  but  applied  to  mucous 
membranes  and  exposed  tissues  they  are  caustic, 
stimulant,  and  astringent.  Internally  in  small  doses 
they  have  the  last  two,  and  also  tonic,  qualities;  and 
in  large  doses  act  on  the  stomach  as  irritants,  causing 
vomiting,  and  on  the  intestines  as  irritant  purga- 
tives. Copper  salts  enter  the  blood  very  slowly, 
and  are  eliminated  by  the  saliva,  bile,  faeces,  anc 
urine.  The  metal  is  not  official. 


THE  METALS.  7 1 

Preparations  of  Copper. 

Cupri  Sulphas. 
Copper  Sulphate. 

Sometimes  called  blue  vitriol,  or  bluestone. 
Externally  it  is  used  as  an  escharotic,  and  internally 
as  a  tonic  and  astringent. 

Symptoms  of  Poisoning. 

In  cases  of  acute  poisoning  by  blue  vitriol,  as  much 
as  §  ss.  or  upwards  will  produce  the  following  symp- 
toms, which  come  on  in  a  few  minutes:  A  strong 
metallic  taste  in  the  mouth;  nausea,  and  vomiting  of 
bluish  or  greenish  liquids;  a  feeling  of  constriction  in 
the  throat;  a  distended  abdomen;  colicky  pains  in  the 
stomach  and  bowels;  diarrhoea  and  tenesmus.  These 
symptoms  are  fully  developed  in  one  or  two  hours. 
Then  follow  rapid  and  difficult  breathing;  small,  quick 
pulse;  great  thirst;  cold  perspiration ;  weakness,  giddi- 
ness, stupor,  coma,  convulsions,  and  paralysis.  Death 
may  occur  in  a  few  hours,  or  be  delayed  several  days. 

Treatment  of  Poisoning. 

Albumin,  as  white  of  egg,  milk,  wheat  flour,  should 
be  given,  and  then,  as  the  albuminate  of  copper  is  not 
entirely  harmless,  the  stomach  should  be  well  washed 
out  with  plenty  of  warm  water.  Stomach-pump  used 
if  necessary.  The  chemical  antidote  is  potassium  ferro- 
cyanide,  but  with  this,  too,  emesis  should  follow 
promptly. 

Average  dose  (medicinal),  gr.  1^-0.004  Gm. 

Average  dose  (emetic),  gr.  iv.-o.25  Gm. 

Copper  poisoning,  acute  and  chronic,  may  result  from 
the  use  of  dirty  copper  dishes  and  cooking  utensils, 
and  from  cooking  acid  fruits  in  copper.  Chronic 
poisoning  is  also  caused  by  the  inhalation  of  the  fumes 
of  copper,  as  in  certain  occupations,  and  by  the  adul- 
teration of  certain  articles  of  food,  as  pickles,  which 


72  MATERIA  MEDIC  A  FOR  NURSES. 

are  sometimes  colored  green  with  copper.  Chronic 
poisoning  presents  the  same  symptoms  as  the  acute 
form,  but  in  a  lesser  degree,  and  death  may  result  from 
exhaustion. 

Alumen,  Alum. 

Alum  is  the  sulphate  of  aluminum  and  potash  and 
has  a  crystalline  form  and  a  taste  which  is  both  acid 
and  sweetish,  and  also  astringent.  It  is  soluble  in 
water,  but  insoluble  in  alcohol. 

Physiological  Actions. 

Alum  is  an  astringent  and  styptic.  In  doses  of 
3  i.  it  is  an  irritant  but  non- depressing  emetic,  and  in 
large  doses  a  purgative.  Taken  into  the  mouth,  the 
flow  of  saliva  is  first  increased  by  alum,  and  afterwards 
diminished,  as  it  hardens  the  albumin  of  the  secretions 
and  contracts  the  capillaries. 

The  same  effect  is  shown  on  the  mucous  membrane 
of  the  stomach.  Alum  is  absorbed  into  the  blood,  not- 
withstanding its  power  of  coagulating  albumin,  and 
checks  capillary  haemorrhage  by  constricting  the 
vessels.  Alum  should  always  be  given  alone,  and 
it  is  to  be  remembered  that  it  has  a  very  injurious 
action  on  the  teeth. 

Symptoms  of  Poisoning. 

In  large  doses  alum  produces  gastro-enteritis,  with 
frothing  at  the  mouth.  The  treatment  consists  in  pro- 
moting vomiting  and  washing  out  the  stomach,  giving 
magnesium  hydrate  in  large  quantities,  or  a  weak 
solution  of  ammonium  carbonate  at  intervals.  Death 
has  been  caused  in  eight  hours  in  an  adult  by  §  ii.  of 
alum. 

Preparations  of  Alum. 

Alumini  Hydroxidum. 
Aluminum  Hydroxide. 

The  average  dose  of  alum  is  gr.  viii.-o.5  Gm.  Any 
preparation  should  be  taken  through  a  tube. 


THE  METALS.  73 


Alumen  Exsiccatum. 
Exsiccated  Alum. 


Alum  which  has  been  deprived  of  its  water  by  heat, 

and  powdered.     Combined  with  alcohol  (in  which  it 

is  insoluble),  in  the  proportion  of  3  i.-iv.  to  alcohol 

5  v.-vi.,  it  is  used  to  harden  the  skin,  as  a  preventive 

of  bed-sores. 


Ferrum    (Iron). 

All  the  salts  and  preparations  of  iron  are  made 
directly  or  indirectly  from  the  metal. 

Physiological  Actions. 

Iron  is  the  most  important  of  the  mineral  tonics,  and 
may  be  more  properly  described  as  a  food  rather  than 
as  a  medicine,  being  one  of  the  most  essential  constitu- 
ents of  the  red  blood  corpuscles.  It  exists  normally  in 
the  blood  in  the  proportion  of  i  part  iron  to  230  parts 
red  corpuscles,  and  in  a  state  of  health  enough  iron  is 
taken  with  various  kinds  of  food,  to  supply  the  demand. 
Beef  especially,  as  an  article  of  diet,  provides  iron,  as 
it  contains  i  part  iron  to  194  parts  red  corpuscles. 

Iron  has  been  called  the  great  respiratory  food.  In 
the  lungs  it  takes  up  oxygen  from  the  inspired  air,  and 
carries  it  to  all  the  tissues.  No  function  of  the  body 
can  be  carried  on  without  oxygen;  the  muscular  system 
especially  is  dependent  for  its  perfect  activity  on  the 
presence  of  oxygen,  and  muscular  power  is  in  direct 
proportion  to  the  efficiency  of  the  respirations. 

The  feeling  of  tone  and  energy,  both  bodily  and 
mental,  which  belongs  to  perfect  health,  comes  from  an 
ample  supply  of  oxygen,  and  it  is  in  this  primary  way 
that  iron  acts  as  a  tonic  ;  stimulates  and  strengthens 
the  heart,  nerves,  and  muscles ;  raises  the  tem- 
perature of  the  body  and  increases  the  appetite. 

It  is  not  absorbed  by  the  unbroken  skin,  but  on 


74  MATERIA  MEDIC  A  FOR  NURSES. 

exposed  tissue  and  mucous  surfaces  its  action  is  astrin- 
gent, coagulating  the  albumin  of  tissue  and  plasma, 
diminishing  the  circulation  by  compression  of  the  ves- 
sels, and  arresting  hemorrhage.  Iron  is  thus  classed 
as  a  styptic  or  haemostatic. 

Taken  internally  there  is  an  astringent  taste,  and  the 
tongue  and  teeth  are  darkened  by  a  sulphide  which  is 
deposited  as  a  result  of  decomposition.  If  given  in 
excess  or  on  an  empty  stomach  it  decomposes  the 
digestive  fluid,  and  acts  as  an  irritant  and  astringent 
upon  the  mucous  membrane. 

The  digestion  or  absorption  of  iron  takes  place  partly 
in  the  stomach  and  partly  in  the  intestines,  and  depends 
upon  the  presence,  in  normal  quantities,  of  the  gastric 
and  intestinal  juices. 

Organic  and  inorganic  compounds  of  iron  are  be- 
lieved to  be  absorbed  with  equal  readiness  in  the 
alimentary  canal,  principally  in  the  duodenum,  whence 
they  pass  to  the  spleen,  where  they  are  stored 
up,  being  given  off  to  the  blood  later,  and  carried  to 
the  liver,  where  they  assist  in  forming  haemoglobin. 
Some  part  of  the  iron  is  afterwards  taken  into  the 
blood,  and  is  excreted  by  the  caecum  and  large  intestine. 
This  is  the  prevalent  view  regarding  the  absorption  of 
iron  and  its  distribution  throughout  the  system.  Some 
claim  that  the  inorganic  iron  combines  with  the  sulphur 
in  the  intestines,  forming  the  sulphide  of  iron  which  is 
excreted  in  the  faeces,  thus  leaving  all  the  food  iron  to 
be  absorbed.  Part  of  the  food  iron  would  be  taken  into 
combination,  otherwise,  by  the  sulphur,  preventing 
absorption. 

Iron  has  sometimes  an  irritant  action  on  the  bladder; 
its  astringency  in  the  alimentary  canal  causes  constipa- 
tion; and  it  is  said  that  it  decreases  the  secretion  of 
milk  in  nursing  women.  An  excess  of  iron  is  elimi- 
nated from  the  system  in  almost  every  possible  way, 
but  principally  by  the  faeces,  which  it  colors  black  by 
forming  a  sulphide. 

The  local  irritant  action  of  iron  explains  why  it  ia 
always  given  well  diluted  and  after  meals. 


THE  METALS.  75 

Incidental  Effects. 

In  administering  a  course  of  iron,  two  things  must 
be  provided  for: 

1.  The  bowels  must  be  loose. 

2.  The  digestion  must  be  good  ;  and  in  the  course  of 
administration  any  one  or  more  of  the  following  symp- 
toms may  be  noticed,  indicating  an  excess  in  the  system: 
frontal  headache,  slight  disturbances  of  the  digestion, 
irritation  of  the  stomach  or  of  the  bladder,  a  feeling  of 
weight  at  the  epigastrium,  constipation,  a  feverish  con- 
dition.    An  acne  of  the  face  and  chest  is  sometimes 
produced  by  iron,  and  the  reduced  iron  causes  eructa- 
tions of  gas. 

It  is  very  important  to  remember  that  all  preparations 
of  iron  stain  clothing,  carpets,— in  fact  everything 
touched,  and  that  the  stains  are  with  difficulty  removed. 
Silver  spoons  should  never  be  used  for  iron,  but  if  they 
have  been  used,  the  stain  will  come  off  if  rubbed  with 
ammonia  water  undiluted.  Oxalic  acid  will  take  the 
stains  out  of  muslin  or  linen. 

Preparations  of  Iron. 

The  five  preparations  of  iron  which  are  especially 
prescribed  because  of  their  effectiveness  and  because 
they  are  the  least  irritating  of  the  iron  compounds  are: 

Tincture  of  the  chloride. 

Syrup  of  the  iodide. 

Solution  of  the  acetate  of  iron  and  ammonia  ("  Bas~ 
ham's  Mixture"). 

Pills  of  the  carbonate  ("  Blaud's  Pills"). 

Iron  and  potassium  tartrate. 

(Saline  Combinations.) 
Tinctura  Ferri  Chloridi. 
Tincture  of  Ferric  Chloride. 

Sometimes  called  the  muriated  tincture. 
It  is  reddish-yellow  in  color,  and  has  peculiar  prop- 
erties.     It   is    the   most    frequently    used   of  all    the 


76  MATERIA  MEDICA  FOR  NURSES. 

preparations  of  iron.  It  is  astringent,  irritating, 
and  somewhat  corrosive.  It  has  diuretic  and  anti- 
spasmodic  qualities,  owing  probably  to  the  ether,  and 
is  antiseptic  by  virtue  of  the  chlorine  and  iron;  tonic, 
as  are  all  iron  preparations.  It  contains  about  4$  of 
metallic  iron. 

Tr.  of  iron  should  never  be  given  at  the  same  time 
with  tea,  or  with  other  medicines  containing  tannin, 
as  an  ink-like  combination  results.  It  should  not  be 
added  to  whiskey,  but  may  be  well  given  in  milk,  being 
dropped  in  at  the  moment  when  it  is  to  be  taken.  It 
may  be  given  with  glycerin,  3  parts  to  iron  i  part,  the 
glycerin  to  prevent  constipation,  or  it  may  be  dropped 
into  egg  albumen  to  prevent  its  action  on  the  teeth.  It 
is  a  very  incompatible  drug,  and  should  not  be  given 
at  the  same  time  that  another  drug  is  administered. 
Iron  attacks  the  teeth,  unless  properly  diluted,  and 
should  always  be  given  through  a  glass  tube.  When 
the  throat  is  gargled  with  iron,  the  teeth  should  be 
brushed  after  each  application,  or  washed  off  with  salt 
water. 

Average  dose,  TT[  viii.-o.5  mil,  half  an  hour  after 
meals,  in  a  tumblerful  of  water. 

Liquor  Ferri  et  Ammonii  Acetatis. 
Solution  of  Iron  and  Ammonium  Acetate. 
Basham's  Mixture. 

Composed  of  tr.  of  ferric  chloride,  diluted  acetic  acid, 
solution  of  ammonium  acetate,  elixir  of  orange,  glycerin, 
and  water.  It  should  be  freshly  made. 

Average  dose,  3  iv.-i5  mils,  well  diluted. 

Syrupus  Ferri  lodidi. 
Syrup  of  Ferrous  Iodide. 

Iodide  of  iron  affects  the  teeth  seriously.  It  has 
iodine,  iron,  and  syrup,  and  exerts  a  special  action  on 
nutrition  by  means  of  the  iodine. 

Average  dose,  TT[  xv.-i  mil,  largely  diluted. 


THE  METALS.  77 

Mistura  Ferri  Composita. 
Compound  Iron  Mixture. 
(Griffith's  Mixture.) 

Contains  ferrous  sulphate,  potassium  carbonate,  and 
myrrh. 

Dose,   ^  ss.-i5  mils. 

/ ' 
Liquor  Ferri  Subsulphatis. 

Solution  of  Ferric  Subsulphate. 
Monsel's  Solution. 

Contains  about  13  %  of  metallic  iron. 

Ferrous  sulphate,  sulphuric  and  nitric  acids  are  con- 
stituents of  Monsel's  solution.  It  has  a  deep  red  color 
and  the  consistency  of  syrup.  It  is  an  active  styptic, 
but  it  is  rather  uncertain  in  its  action,  sometimes  caus- 
ing severe  sloughing,  and  is  not  much  used. 

Liquor  Ferri  Tersulphatis. 
Solution  of  Ferric  Sulphate. 

Contains  about  10  %  metallic  iron.  The  chief  employ- 
ment of  it  is  in  making  other  ferruginous  preparations. 
It  should  always  be  kept  on  hand  for  the  quick  prepara- 
tion of  the  antidote  to  arsenic. 

Pilulae  Ferri  Carbonatis. 
Pills  of  Ferrous  Carbonate. 
Blaud's  Pills. 

Contains  sulphate  of  iron  and  carbonate  of  potassium, 
althaea,  tragacanth,  and  glycerin.  Dose,  pil.  i. 

Ferrum  Reductum. 
Reduced  Iron. 
Quevenne's  Iron. 

A  light  gray  powder,  quite  tasteless,  and  of  all  the 
preparations  of  iron  the  most  free  from  astringency. 
Dose,  gr.  i.-o-o6  Gm.,  taken  after  meals  in  pill  form. 
It  may  be  given  to  children  in  candy  or  lozenges. 


78  MATERIA   MEDICA   FOR  NURSES. 

Pilulae  Ferri  lodidi. 
Pills  of  Ferrous  Iodide. 

Contain  reduced  iron,  iodine,  glycyrrhiza,  acacia,  and 
balsam  of  tolu.  Dose,  pil.  i. 

Ferri  et  Quininae  Citras. 
Iron  and  Quinine  Citrate. 

Contains  about  12%  of  quinine.  It  should  not  be 
exposed  to  the  light. 

Average  dose,  gr.  iv.-o.25  Gm. 

Ferri  Sulphas  Granulatus. 
Granulated  Ferrous  Sulphate. 

Average  dose,  gr.  iss.-o.i  Gm. 

Ferri  Phosphas. 
Ferric  Phosphate. 

Contains  not  less  than  12%  of  iron.     It  should  not 
be  exposed  to  light. 
Average  dose,  gr.  iv.-o.25  Gm. 

(Antidotes  to  Arsenic.) 

Ferri  Hydroxidum. 
Ferric  Hydroxide. 

As  an  antidote  to  arsenic  this  preparation  of  iron 
must  be  fresh,  and  may  be  quickly  prepared  by  adding 
to  several  ounces  of  the  tr.  ferri  chlor.  enough  ammonia 
water  or  sodium  carbonate  to  form  a  precipitate,  which 
will  appear  almost  instantly.  Continue  adding  the 
alkali  until  no  more  of  the  precipitate  falls;  then  turn 
it  into  a  piece  of  muslin  or  a  fine  strainer  and  wash  it 
well  by  letting  cold  water  run  freely  through  it,  until 
all  traces  of  the  soda  or  ammonia  are  removed.  Stir 
up  a  tablespoonful  of  the  precipitate  in  milk  or  water, 
and  give  it,  repeating  as  often  as  necessary.  It  is 
harmless.  About  8  grains  of  it  are  required  to 
neutralize  i  grain  of  the  poison. 


THE  METALS.  79 

Ferri  Hydroxidum  cum  Magnesii  Oxido. 
Ferric  Hydroxide  with  Magnesium  Oxide. 

Made  by  combining  the  solution  of  the  ferric  sulphate 
with  magnesia.  It  is  said  to  be  the  best  antidote  for 
arsenic.  Dose  as  antidote,  §  iv.-i2o  mils. 

Dialyzed  Iron.    Not  official. 

An  antidote  to  arsenic;  also  given  medicinally.  It 
is  said  that  it  does  not  blacken  the  teeth  nor  constipate. 
Dose,  from  20  to  40  drops.  It  should  always  be  given 
alone. 

Manganesium  (Manganese). 

Manganese  is  found  native  in  the  form  of  the  black 
oxide.  Not  official  as  such. 

Physiological  Actions. 

Manganese  is  found  in  the  human  body  associated 
with  iron.  They  are  found  together  in  the  blood,  hair, 
and  bile,  the  proportion  in  the  blood  being  i  part  of 
manganese  to  20  of  iron.  The  preparations  of  man- 
ganese are  gastro-intestinal  irritants.  In  small  doses 
they  aid  digestion  and  promote  appetite.  They 
enter  the  blood  probably  as  albuminates.  Used  in  ex- 
cess they  lower  the  heart  action,  diminish  the  pulse 
rate,  and  cause  loss  of  muscular  power  and  paralysis. 

The  action  of  manganese  on  the  tissues,  blood,  and 
excretory  organs  is  not  clearly  defined.  It  is  supposed 
that  the  salts  are  decomposed  before  being  absorbed, 
except  when  in  poisonous  doses. 

Preparations  of  Manganese. 

Potassii  Permanganas. 
Potassium  Permanganate. 

Made  from  the  black  oxide  of  manganese,  potassium 
chlorate,  and  a  solution  of  caustic  .potash,  by  a  very 
elaborate  chemical  process.  It  has  the  form  of  dark- 
purple  slender  prisms,  inodorous,  with  an  astringent, 


80  MATERIA  MEDIC  A  FOR  NURSES. 

sweet  taste;  soluble  in  16  parts  of  water.  It  should 
be  kept  in  the  dark. 

Potassium  permanganate  in  the  pure  state  is  irritant 
and  caustic.  In  solution  it  is  stimulating  and  heal- 
ing. In  the  latter  form  it  gives  out  oxygen  in  the  form 
of  ozone,  and  changes  into  hydrated  peroxide  of  man- 
ganese, losing  its  purple  color  and  becoming  brown. 
This  change  does  not  occur  with  the  crystals. 

This  oxidizing  power  gives  it  special  attributes  as  an 
antiseptic,  disinfectant,  and  deodorant,  but  prac- 
tically it  is  not  useful  in  disinfecting  excreta,  as  the 
amount  required  to  be  effectual  would  make  it  enor- 
mously expensive. 

It  is  oftenest  and  most  satisfactorily  used  as  a  deodor- 
izer, in  the  one-per-cent  solution,  as  a  wash,  douche, 
spray,  or  gargle,  for  foul,  carious,  or  gangrenous  dis- 
charges. It  is  also  used  in  skin  disinfection,  in  a 
supersaturated  solution. 

The  stains  made  upon  linen  by  this  salt  may  be  re- 
moved with  oxalic  acid,  lemon  juice,  or  water  with 
muriatic  acid. 

Given  internally,  the  dose,  gr.  ss.-ii.,  is  freely  diluted 
with  distilled  water;  or,  if  given  in  pellets,  boiled  or 
filtered  water  should  be  given  with  it  to  dilute  it  after 
being  swallowed.  It  .should  be  given  on  an  empty 
stomach. 

Mangani  Sulphas. 
Manganese  Sulphate. 

In  full  doses  an  emetic  and  cathartic,  with  action 
on  the  liver,  as  is  shown  by  the  bile  discharged  after 
purgative  doses.  Dose,  gr.  ii.-v.  (0.1-0.3  Gm.) 

Hydrargyrum   Mercury. 
Quicksilver. 

Mercury  is  obtained  from  cinnabar  by  roasting  and 
distilling  with  lime.  It  is  a  silver-white  metal,  liquid, 
and  giving  off  vapor  at  ordinary  temperatures,  and 
capable  of  being  entirely  volatilized  by  heat.  All  the 


THE  METALS.  8 1 

different  preparations  are  derived  directly  or  indirectly 
from  the  metal  itself. 

Physiological  Actions. 

In  the  metallic  form  mercury  is  inert,  large  amounts 
of  the  pure  metal  having  been  swallowed  and  dis- 
charged from  the  intestines  without  poisoning  or  injury; 
but  in  the  form  of  vapor,  or  any  of  its  preparations,  it  is 
very  readily  absorbed  by  the  pulmonary  and  other 
mucous  membranes,  by  the  alimentary  canal,  and  by 
the  skin  and  tissues,  either  whole  or  broken.  The 
constitutional  effects  may  be  reached  in  any  one  or  all 
of  these  ways. 

All  mercurials  are  antiseptic  and  disinfectant. 

The  local  action  of  mercury  in  moderate  strength, 
either  externally  or  internally,  is  astringent,  anti- 
phlogistic, and  stimulant.  In  large  or  concentrated 
doses  it  is  irritant  to  the  stomach  and  intestines,  and  in 
some  forms  is  a  locally  acting  purgative. 

In  various  pathological  conditions  of  the  system 
mercury  exerts  an  influence  as  an  alterative,  through 
some  power  over  nutrition  which  is  not  perfectly  under- 
stood. It  is  considered  a  specific  in  some  forms  of 
syphilis. 

Mercury  is  excreted  by  the  saliva,  perspiration, 
milk,  urine,  and  bile. 

Symptoms  of  Poisoning". 

The  mildest  evidences  of  over-doses  of  mercury  are: 
slight  fetor  of  the  breath  and  isoreness  if  the  teeth  are 
knocked  together  or  struck;  a  metallic  taste  next  ap- 
pears. After  this  comes  salivation,  an  abnormal  amount 
of  fluid  being  poured  out  from  the  salivary  glands,  and 
small  ulcers  appear  on  the  lips,  gums,  and  tongue.  A 
feeling  of  constriction  of  the  throat,  which  is  found 
among  the  symptoms  of  acute  poisoning,  has  been 
caused  in  some  susceptible  persons  by  a  single  medici- 
nal dose  of  mercury. 

When  its  use  is  continued  beyond  this  point  saliva- 


82  MATERIA   MRDICA  FOR  NURSES. 

tion  increases.  The  gums  become  swollen  and  spongy, 
and  bleed  easily.  The  tongue  swells,  sometimes  pro- 
truding from  the  mouth.  The  teeth  are  loosened,  and 
a  dark  line  is  seen  at  their  upper  margin.  In  some 
cases  ulceration  of  the  soft  parts  and  necrosis  of  the 
jaw-bones  result.  In  pronounced  chronic  poisoning, 
in  addition  to  these  symptoms,  there  are  abdominal 
pains,  nausea,  vomiting  and  diarrhoea,  anaemia,  ema- 
ciation and  general  weakness;  aching  pains  in  the 
bones  and  joints;  loss  of  hair;  a  trembling  or  shaking 
palsy ;  and  paralysis,  with  a  brown  tint  of  the  skin.  In 
some  cases  there  is  wrist-drop.  Chronic  poisoning  may 
be  caused  indirectly  by  exposure  to  the  metal  or  its 
fumes,  as  in  various  occupations,  and  it  may  come  on 
very  suddenly. 

When  chronic  poisoning  by  mercury  is  evident,  the 
drug  should  be  stopped  immediately,  the  throat  and 
mouth  gargled  regularly  with  a  solution  of  potassium 
chlorate,  and  atropine  may  be  given  to  lessen  the  exces- 
sive secretion  of  saliva,  while  potassium  iodide  is  used 
to  eliminate  the  mercury  from  the  tissues. 

Acute  poisoning  will  be  described  tinder  corrosive 
sublimate. 

Preparations  of  Mercury. 

Hydrargyri  Chloridum  Corrosivum. 
Corrosive  Mercuric  Chloride. 
Corrosive  Sublimate. 

Known  as  bichloride  of  mercury,  or  "  bichloride.'* 
Made  by  subliming  bisulphate  of  mercury  with  chloride 
of  sodium.  Soluble  in  16  parts  of  cold  water.  It  is  a 
powerful  germicide  under  certain  conditions,  and  is 
ordinarily  used  as  a  disinfectant  solution  for  the  skin, 
for  dressings,  etc.,  in  a  strength  of  1:1000.  It  is  not 
an  efficient  disinfectant  in  the  case  of  stools,  or  bloody 
or  purulent  discharges,  as  it  hardens  albumin,  thus 
forming  a  protective  shell  within  which  germs  retain 
perfectly  their  vitality.  White  materials  are  stained 


THE  METALS.  83 

yellow  by  bichloride  of  mercury,  and  it  is  not  always 
desirable  therefore  as  a  disinfectant  for  clothing.1 

The  external  use  of  bichloride  of  mercury,  as  in  dress- 
ing surgical  and  obstetrical  cases,  may  produce  symp- 
toms of  poisoning  which  must  not  be  overlooked. 
Among  the  latter  class  of  cases  an  eruption  of  small 
pimples  appears  about  the  buttocks  and  may  extend 
down  the  limbs.  Sore  gums,  fetid  breath,  and  saliva- 
tion may  follow.  The  eruption  should  always  be 
reported  as  soon  as  noticed.  In  chronic  poisoning  by 
this  preparation  there  is  more  tendency  to  abdominal 
pains,  diarrhoea,  and  colic. 

Internally  in  small  over-doses  it  causes  nausea,  burn- 
ing in  the  stomach,  colicky  abdominal  pain,  and 
diarrhoea;  or,  these  symptoms  may  not  be  prominent 
and  a  sore  ulcerated  mouth  may  show  the  toxic  action. 
In  poisonous  doses  it  is  a  violent  irritant  and  caustic, 
and  the  symptoms  appear  in  a  few  moments — viz.,  a 
metallic  taste,  the  mucous  lining  of  the  mouth  some- 
times glazed  and  white,  vomiting  of  mucus  and  blood, 
dysenteric  purging,  tenesmus,  and  cramps,  with  fetid 
breath.  Violent  abdominal  pain  is  sometimes,  not 
always,  present.  The  urine  is  diminished,  may  con- 
tain blood  and  albumin,  may  be  suppressed.  In  the 
course  of  two  or  three  hours  there  is  collapse,  with 
small,  quick,  irregular  pulse,  pinched,  anxious  face, 
cold  extremities,  syncope,  convulsions,  coma,  and 
death. 

The  smallest  fatal  dose  is  not  absolutely  certain,  but 
may  be  put  at  3  to  5  grains.  Death  usually  takes  place 
in  from  i  to  5  days,  but  may  be  earlier  or  later  than  this. 
On  recovery  the  convalescence  is  long  and  tedious. 

The  antidote  is  albumin,  milk,  gluten  (flour),  or,  best 
of  all,  the  white  of  egg,  in  proportion  of  i  egg  to  4 
grains  of  the  poison.  More  than  this  is  said  to  redis- 
solve  the  mercury. 


1  For  this  purpose  the  solution  of  salt  and  sulphate  of  zinc  is 
better.    See  zinc. 


84  MATERIA   MEDIC  A    FOR   NURSES. 

Vomiting  should  be  promptly  induced  and  actively 
kept  up  for  a  time  after  taking  the  antidote. 

Average  dose,  gr.  ^-0.003  Gm.,  well  diluted  and  given 
after  meals.  All  other  non-purgative  preparations  are, 
as  a  rule,  taken  after  meals  also. 

Hydrargyri  Salicylas. 
Mercuric  Salicylate. 

Average  dose,  gr.  iV-o.oc>4  Gm. 

Hydrargyri  lodidum  Flavum. 
Yellow  Mercurous  Iodide. 
Protoiodide  of  Mercury. 

Average  dose,  gr.  i-o.oi  Gm. 

Hydrargyri  lodidum  Rubrum. 
Red  Iodide  of  Mercury. 
Biniodide  of  Mercury. 

Average  dose,  gr.  75-0.003  Gm. 

Hydrargyri  Chloridum  Mite. 
Mild  Mercurous  Chloride. 

Calome, 

Made  by  subliming  sulphate  of  mercury  and  chloride 
of  sodium.  A  white,  insoluble  powder,  used  as  a 
cathartic  and  indirect  cholagogue. 

It  increases  the  amount  of  bile  evacuated  from  the 
intestines  without  directly  increasing  the  amount 
secreted  by  the  liver.  In  the  ordinary  routine  of  diges- 
tion part  of  the  bile  in  the  intestines  is  re-absorbed  and 
carried  back  to  the  liver;  but  by  the  action  of  calomel 
this  is  all  expelled  from  the  body,  the  result  being  that 
the  next  quantity  secreted  must  all  be  newly  formed, 
out  of  fresh  materials. 

Salivation  occurs  more  frequently  from  the  use  of 
calomel  than  from  other  mercurials  except  blue  pill, 
and  it  has  an  insidious  harmful  effect  on  the  teeth, 
tending  to  retract  the  g-ums  and  expose  the  unprotected 


THE  METALS.  ?5 

roots.  Being  tasteless  and  insoluble,  it  is  best  given 
dry  on  the  tongue,  with  some  water  after  it.  It  is  slow 
in  its  action,  requiring  from  8  to  12  hours  if  given  alone. 
Salty  food  should  not  be  taken  after  calomel,  as  alka- 
line chlorides  change  it  into  bichloride.  Acids  also  are 
often  forbidden,  though  this  is  not  now  considered  very 
important. 

It  should  never  be  used  as  a  home  remedy.  Average 
dose,  gr.  i.-o.o6  Gm.,  as  laxative. 

Massa  Hydrargyri.    Mass  of  Mercury. 
Blue  Mass. 

Made  by  combining  mercury  in  the  metallic  state 
with  glycyrrhiza,  althaea,  etc.  It  contains  one  third 
its  weight  of  the  metal,  and  is  used,  like  calomel,  as  a 
purgative,  but  is  milder.  Bach  pill  contains  usually 
from  3  to  5  grains  of  the  mass,  equalling  gr.  J  of  metal. 
Average  dose,  gr.  iv.-o.25  Gm. 

Hydrargyrum  cum  Creta. 
Mercury  with  Chalk. 

A  gray  powder,  similar  in  its  properties  and  strength 
to  blue  mass.  It  may  be  placed  dry  on  the  tongue 
or  mixed  with  glycerin.  Dose,  gr.  i.-v.  (0.06-0.25 
Gm.)  The  mercurial  purgatives  are  abused  by  num- 
bers of  persons  who  prescribe  for  themselves.  They 
should  never  be  taken  without  authority,  and  it  is  also 
to  be  remembered  that  many  quack  purgative  medi- 
cines, "  liver  pills,"  etc.,  contain  mercury  in  uncertain 
quantities,  and  are  harmful. 


Unguentum  HydrargyrL 
Mercurial  Ointment. 

Composed  of  mercury,  benzoinated  lard,  suet,  and 
oleate  of  mercury.  Strength  about  50%.  The  diluted 
ointment  is  called  "  blue." 


86  MATERIA  MEDICA  FOR  NURSES. 

Unguentum  Hydrargyri  Oxidi  Flavi. 
Ointment  of  Yellow  Mercuric  Oxide. 

Strength,  io#. 

Unguentum  Hydrargyri  Ammoniati. 
Ointment  of  Ammoniated  Mercury. 

Strength,  10$. 

Unguentum  Hydrargyri  Nitratis. 
Ointment  of  Mercuric  Nitrate. 
Citrine  Ointment. 

Strength,  7  <f>.     Contains  also  nitric  add* 

Black  Wash.    Not  official. 
Calomel  3  i,  lime-water  O.  j.    Used  externally. 

Yellow  Wash.   Not  official. 

Corrosive   sublimate    3ss,   lime-water  O.  j.     Used 

externally. 

These  two  washes  depend  for  their  efficacy  on  the 
black  and  yellow  oxides  which  are  formed  by  the 
union  with  lime-water.  They  are  used  for  syphilitic 
ulcers.  The  yellow  wash  is  the  more  stimulating. 

Mercury,  besides  being  given  internally,  is  used  in 
the  form  of  vapor  baths  and  inunctions.  There  are 
many  preparations,  and  with  all  of  them  constitutional 
symptoms  are  likely  to  appear,  and  must  always  be 
watched  for. 

It  is  of  great  importance  that  the  diet  of  persons 
taking  mercury  should  be  ample  and  nutritious. 

The  bowels  should  be  kept  open  and  the  teeth  should 
be  kept  clean  in  order  to  prevent  salivation. 

Mercurial  ointment  should  be  rubbed  in  with  a  piece 
of  flannel  and  the  nurse's  hand  must  be  well  protected 
to  prevent  absorption. 


THE  METALS.  87 

Arsenium  (Arsenic). 
Metallic  arsenic  is  inert,  and  is  not  used  in  medicine. 

Arseni  Trioxidum.    Arsenic  Trioxide. 
Arsenous  Acid. 
White  Arsenic. 

Obtained  principally  as  a  secondary  product  in  the 
roasting  of  cobalt  ores.  It  is  not  a  true  acid,  but  an 
anhydride,  or  acid  deprived  of  its  water.  All  the  prep- 
arations of  arsenic  are  derived  from  white  arsenic. 

Physiological  Actions. 

Arsenic  in  concentrated  form  applied  to  the  tissues 
causes  inflammation,  followed  by  ulceration  and 
sloughing.  It  has  therefore  been  used  as  an  escha- 
rotic,  but  its  action  is  very  painful  and  is  attended 
with  danger,  as  arsenic  is  readily  absorbed  from  broken 
skin,  ulcers,  and  mucous  membrane,  unless  there  is 
enough  inflammation  to  throw  it  off;  it  being  under- 
stood that  when  an  inflammatory  process  is  going  on, 
the  absorptive  capacity  of  that  part  is  checked. 

In  the  stomach  in  medicinal  doses  arsenic  does  not 
combine  with  the  albuminous  contents  of  the  organ, 
but  remains  unchanged  and  acts  directly  on  the  mucous 
membrane,  stimulating  the  nerves  and  vessels,  caus- 
ing a  sense  of  heat  and  hunger,  and  promoting  the 
gastric  functions. 

Arsenic  enters  all  organs  and  tissues,  increases  tissue 
changes  and  the  vital  activity  of  the  whole  system. 
It  does  not  combine  with  the  tissues,  and  is  excreted 
chiefly  by  the  urine,  and  also  by  the  skin,  liver,  and 
intestines.  Arsenic  is  therefore,  in  medicinal  doses,  a 
stomachic  and  general  tonic,  increasing  the  appetite 
and  improving  digestion  and  general  nutrition. 

It  stimulates  the  secretions,  peristaltic  action,  the 
brain,  heart,  and  respiratory  centre. 


88  MATERIA  MEDIC  A   FOR  NURSES. 

Symptoms  of  Poisoning. 

In  giving  arsenic,  the  first  signs  which  indicate  over- 
dosing are:  a  slight  puffiness  about  the  eyelids,  without 
redness,  and  noticeable  first  in  the  early  morning,  dis- 
appearing later;  an  itching  of  the  eyelids;  tingling  or 
itching  of  the  fingers,  abdominal  pain  or  soreness.  In- 
creasing  symptoms  of  over-dosing  are:  a  metallic  taste, 
nausea,  vomiting,  diarrhoea,  and  sometimes  dysenteric 
stools,  with  tenesmus;  an  irritable  and  feeble  heart 
action;  palpitations  and  oppressed  breathing;  eczema 
and  other  skin  eruptions;  trembling  and  stiffness  of  the 
joints;  and  albuminuria. 

In  acute  arsenical  poisoning  two  effects  are  produced 
upon  the  tissues: 

1.  The  epithelium  of  mucous  membranes  is  desqua- 
mated, especially  in  the  alimentary  canal. 

2.  The  blood-vessels  in  the   splanchnic    area    are 
widely  dilated. 

These  two  conditions  give  rise  to  clear  watery  stools 
—"rice  water  stools,'* — which  are  characteristic  of 
arsenical  poisoning  and  Asiatic  cholera. 

In  acute  poisoning  the  symptoms  are  of  two  varieties, 
gastro-intestinal  and  cerebral.  The  former  is  much 
more  common,  and  is  marked  by  a  burning  pain  at  the 
epigastrium,  radiating  over  the  abdomen;  violent  and 
uncontrollable  vomiting  of  matter,  first  mucous,  then 
bilious,  and  finally  serous;  intense  thirst  and  dryness 
of  the  mouth  and  throat;  stools  bloody  and  offensive, 
sometimes  involuntary;  strangury;  sometimes  bloody 
urine,  or  suppression;  great  restlessness  and  agitation; 
dyspnoea ;  a  rapid,  weak,  intermittent  pulse ;  cold 
breath;  shrunken  face;  cold  and  clammy  skin,  and 
final  collapse,  consciousness  being  retained  until  death 
occurs.  In  the  cerebral  form  there  is  sudden  and  deep 
insensibility,  ending  in  death,  without  intestinal  symp- 
toms. Occasionally  there  is  a  combination  of  both  sets 
of  symptoms;  also  they  may  vary  according  to  the  form 
and  dose  in  which  the  poison  has  been  taken.  The 
time  in  which  they  come  on  is  usually  from  half  au 


THE  METALS.  89 

hour  to  an  hour  after  taking  the  poison,  and  death  has 
occurred  in  a  few  hours,  but  the  average  length  of  time 
is  about  twenty-five  hours.  It  often  happens  that  re- 
covery is  made  from  the  first  effects,  with  death  from 
exhaustion  or  secondary  causes  many  days,  or  even 
weeks,  after. 

The  signs  to  be  watched  for  in  the  administration  of 
arsenic  are: 

1.  Puffmess  about  the  eyes  in  the  early  morning. 

2.  Constriction  of  the  throat. 

3.  Gastric   disturbances — indigestion,  pain,  nausea, 
etc. 

4.  Pigmentation  of  the  skin. 

5.  "  Rice  water  stools." 

The  arsenic  should  be  discontinued  for  a  short  time, 
but  may  be  resumed  unless  the  symptoms  were  alarm- 


ing. 
Tl 


*he  fatal  dose  for  an  adult  may  be  put  at  from  2  to  4 
grains. 

Treatment  of  Poisoning. 

In  treating  poisoning  by  arsenic,  if  vomiting  has  not 
already  been  caused  by  the  poison,  emetics  should  be 
given:  a  tablespoonful  of  mustard  in  a  glass  of  warm 
water,  followed  by  large  quantities  of  mucilaginous  and 
albuminous  drinks,  such  as  flaxseed  tea,  milk,  with 
white  of  egg,  etc.  The  antidotes,  hydrated  sesquiox- 
ide  of  iron  and  hydrated  magnesia,  have  been  described 
under  iron  and  may  be  given  in  water,  a  tablespoonful 
at  a  time,  every  few  minutes  while  necessary.  Castor- 
oil  should  be  given  to  clear  the  bowels.  If  the  poison 
has  been  taken  in  solution,  the  antidotes  will  precipitate 
it  in  an  insoluble  form,  but  no  confidence  can  be  placed 
in  them  if  the  powder  has  been  taken,  as  rat-poison 
(often  used  in  suicidal  cases).  The  early  and  complete 
removal  of  the  poison  by  emetics  and  purgatives  is  then 
the  only  real  hope.  The  urine  must  be  watched,  as 
suppression  may  occur,  and,  while  the  patient  lives,  a 
daily  specinen  saved  for  examination. 

Arsenic  is  not  accumulative,  and  is  an  irritant,  not 


90  MATERIA  MEDICA  FOR  NURSES. 

a  corrosive,  poison.  After  death  the  stomach  and  in- 
testines are  found  to  be  deeply  reddened  and  inflamed, 
but  not  ulcerated.  The  post-mortem  appearances,  as 
well  as  many  of  the  symptoms,  resemble  those  of  chol- 
era very  strongly.  Chronic  poisoning  is  caused  by  the 
inhalation  of  arsenical  fumes,  by  the  use  of  wall-papers 
and  clothing  dyed  with  materials  containing  arsenic, 
and  by  eating  adulterated  candy  and  other  articles  of 
food. 

Preparations  of  Arsenic. 

Arseni  Trioxidum. 
Arsenic  Trioxide. 
Arsenous  Acid. 

Average  dose,  gr.  ^-0.002  Gm.,  well  diluted  and 
given  after  meals. 

Liquor  Acidi  Arsenosi. 
Solution  of  Arsenous  Acid. 

Contains  arsenic  trioxide  i  part  in  100,  and  diluted 
hydrochloric  acid  5  parts  in  100. 

Average  dose,TTj,  iii.-o.2  mil,  well  diluted  and  given 
after  meals. 

Liquor  Potassii  Arsenitis. 
Solution  of  Potassium  Arsenite. 
Fowler's  Solution  of  Arsenic.  ) 

Contains  tr.  of  lavender  and  arsenic  trioxide  and 
bicarbonate  of  potassium,  i  part  of  arsenic  in  100.  Five 
minims  represent  gr.  ~h. 

Average  dose,  Til  iii.-o.2  mil,  well  diluted  and  given 
soon  after  meals. 

Arseni  lodidum. 
Arsenous  Iodide. 

Average  dose,  gr.  Tr-o.oo5  Gm. 


THE  METALS.  9! 

Liquor  Arseni  et  Hydrargyri  lodidi. 
Solution  of  Arsenous  and  Mercuric  Iodides. 
(Donovan's  Solution.) 

A  very  powerful  alterative,  containing  i  %  each  of 
iodide  of  arsenic  and  red  iodide  of  mercury.  It  is 
capable  of  acting  as  a  corrosive  poison,  and  may  sali- 
vate. Locally  it  is  a  violent  irritant. 

Average  dose,  Tt[  ii-o.i  mil,  well  diluted. 

Cupri  Arsenis.     Not  official. 
Paris  Green. 

Is  not  used  medicinally,  but  is  often  taken  as  a  means 
of  suicide. 

It  may  be  repeated  in  conclusion  that  all  preparations 
of  arsenic  should  be  given  well  diluted,  and  soon  after 
meals,  to  avoid  the  local  irritant  action  on  the  stomach; 
and  that  it  is  necessary  to  keep  close  watch  for  the  con- 
stitutional symptoms,  which  may  at  first  be  so  unob- 
trusive as  to  escape  notice. 

Antimonium  (Antimony). 

The  metal  itself  (stibium)  is  not  official,  all  prepara- 
tions being  derived  from  black  antimony,  which  is 
obtained  from  siliceous  matter,  purified  and  powdered. 

Antimonii  et  Potassii  Tartras. 
Antimony  and  Potassium  Tartrate. 
Tartar  Emetic. 

Made  by  boiling  cream  of  tartar  and  water  with 
oxide  of  antimony. 

Tartar  emetic,  applied  to  the  skin,  is  a  strong  coun- 
ter-irritant, and  excites  an  eruption  closely  resembling 
that  of  smallpox,  viz.,  small  papules,  becoming  vesicu- 
lar and  finally  pustular.  It  is  now  but  little  used  in 
this  way.  Internally  it  is  irritant,  and,  as  an  emetic, 
its  action  is  partly  direct — that  is,  acting  immediately 


92  MATERIA  MEDICA  FOR  NURSES. 

on  the  walls  of  the  stomach,  and  partly  indirect,  or 
acting  on  the  nerve-centre  in  the  medulla  which  con- 
trols vomiting.  Tartar  emetic  causes  nausea  and  de- 
pression both  before  and  after  the  act  of  vomiting,  and 
is  therefore  not  well  suited  to  cases  where  rapid  action 
with  as  little  depression  as  possible  is  required,  as  in 
poisoning. 

In  small  continued  doses  the  local  action  of  tartar 
emetic  is  apt  to  produce  loss  of  appetite,  nausea,  diar- 
rhrea,  and  pain.  In  the  tissues  antimony  has  an  alter- 
ative action,  the  special  results  being  an  increase  of  the 
waste  products  of  the  body,  with  a  lessening  of  oxygen- 
ation,  and  fatty  degeneration  of  the  organs. 

Tartar  emetic  depresses  the  circulation  even  in  small 
doses,  the  first  effect  visible  after  a  therapeutic  dose 
being  a  diminution  of  the  pulse  and  increase  of  per- 
spiration. 

With  a  continuance  of  the  medicine  the  pulse  be- 
comes weakened,  soft,  and  compressible,  infrequent 
and  irregular,  and  fainting  may  occur.  Respiration  is 
weakened,  inspiration  being  shortened,  and  expiration 
lengthened. 

The  nervous  system  is  depressed,  a  feeling  of  languor, 
sleepiness,  and  lassitude  being  produced  by  a  moderate 
dose.  It  affects  the  muscular  system  so  powerfully 
that  before  chloroform  came  into  use  tartar  emetic  was 
employed  to  produce  muscular  relaxation  in  the  reduc- 
tion of  dislocations,  etc.,  and  the  depressed  state  so 
brought  about  lasted  for  six  or  eight  days  in  spite  of 
heart  stimulants. 

Emetic  doses  cause  great  muscular  weakness,  trem- 
ors, and  aching  of  the  muscles,  loss  of  power  to  stand, 
with  free  perspiration  and  an  increase  of  saliva. 

Antimony  is  excreted  by  all  the  mucous  surfaces,  the 
liver,  kidneys,  and  skin. 

Its  excretion  by  the  bile  shows  it  to  be  a  hepatic 
Stimulant ;  in  passing  through  the  kidneys  it  acts  as 
a  diuretic,  and  through  the  skin  as  a  diaphoretic. 

The  characteristic  pustular  eruption  is  sometimes 
caused  by  its  internal  use. 


THE  METALS.  93 

Symptoms  of  Poisoning. 

The  symptoms  of  poisoning  are  very  like  those  of 
the  collapse  of  cholera,  viz.:  shrunken  features,  cold 
surface  and  breath;  great  epigastric  pain,  vomiting,  and 
purging;  small,  rapid,  soft,  and  irregular  pulse;  cyano- 
sis; syncope;  cramps  of  the  lower  extremities;  insen- 
sibility to  stimulants;  intense  prostration;  delirium; 
tetanic  spasms  in  some  cases,  or  aphonia. 

The  quantity  of  tartar  emetic  which  will  destroy  life 
is  not  definitely  known.  The  smallest  fatal  dose  re- 
corded is  f  of  a  grain  in  the  case  of  a  child;  gr.  ii.  has 
caused  death  in  an  adult,  while  doses  have  been  re- 
covered from,  ranging  from  gr.  xx.  to  §  i.  It  is  prob- 
able that,  under  ordinary  circumstances  favoring  the 
action  of  the  poison,  gr.  x.  or  xv.  would  destroy  life,  if 
taken  at  once,  or  a  smaller  quantity,  if  divided.  The 
symptoms  come  on  rapidly,  and  death  may  occur  in  a 
few  hours,  or  days,  or  may  be  delayed  for  several  weeks. 

Treatment  of  Poisoning. 

The  antidote  is  tannic  acid;  or  substances  containing 
it,  as  strong  tea.  Opium,  and  alcoholic  stimulants, 
with  demulcent  drinks,  are  given. 

Average  dose  of  tartar  emetic,  gr.  1*2-0.005  Gm., 
diluted. 

Vinum  Antimonii. 

Wine  of  Antimony.    Not  official. 

Contains  of  tartar  emetic  gr.  ii.  to  f  i. 
This  preparation  decomposes  on  being  kept,  and  a 
fungoid  growth  takes  place  in  it  which  unfits  it  for  use. 
It  is  not  considered  useful. 

Syrupus  Scillae  Compositus. 
Compound  Syrup  of  Squill. 

Contains  squill,  senega,  sugar,  and  water,  with  tartar 
emetic,  about  gr.  f  to  ?  i.  Syrup  of  squill  is  some- 
times used  as  a  domestic  remedy  for  children,  without 


94  MATERIA  MEDICA  FOR  NURSES. 

a  physician's  order,  and  as  tartar  emetic  is  not  a  safe 
medicine  for  children,  its  unauthorized  use  has  some- 
times had  fatal  effects,  and  should  always  be  strongly 
discouraged. 

Bismuthum  (Bismuth). 

A  crystalline  metal,  impure  in  its  crude  state,  and 
containing  arsenic  as  one  of  the  impurities.  It  goes 
through  various  chemical  processes  by  way  of  purifica- 
tion. Not  official  as  a  metal. 

Physiological  Actions. 

Externally  and  internally  bismuth  acts  as  a  mild 
sedative  and  astringent.  It  is  useful  as  a  dry  appli- 
cation in  the  first  stages  of  bed-sores,  as  a  dressing  for 
burns  and  blisters,  and  may  be  satisfactorily  used  on 
small  fresh  wounds.  It  is  given  internally  as  an  astrin- 
gent, and  in  large  quantities  colors  the  faeces  black  or 
dark-gray. 

Bismuthi  Subnitras. 
Bismuth  Subnitrate. 

A  heavy  white  powder,  odorless  and  almost  taste- 
less, insoluble  in  water.  The  easiest  way  to  give  it  is 
mixed  in  a  little  glycerin  and  diluted  with  milk  or 
water;  or  it  may  be  given  in  wine,  or  placed  dry  on  the 
tongue. 

Average  dose,  gr.  viii.-o.5  Gm. 

NON-METALLIC  ELEMENTS. 
Phosphorus,  Phosphorus. 

A  non-metallic  element  made  from  bones,  by  treating 
bone-ash  with  sulphuric  acid  and  water.  It  is  a  semi- 
transparent,  almost  colorless,  wax-like  solid,  with  a 
peculiar  garlic  odor;  it  is  luminous  in  the  dark,  is  in- 
soluble in  water,  and  soluble  iu  ether  and  in  oils. 


NON-METALLIC  ELEMENTS.  95 

Phosphorus  is  a  constituent  of  the  most  important 
tissues  of  the  body,  especially  of  the  nervous  system, 
where  it  exists  as  phosphorized  fats.  In  the  bones  it 
is  present  as  phosphate  of  calcium,  magnesium,  and 
sodium.  It  is  contained  in  various  articles  of  food, 
especially  in  fish  and  vegetables. 

Physiological  Actions. 

In  small  doses  phosphorus  acts  as  a  tonic  and  alter- 
ative, and  stimulates  the  nutritive  processes,  especially 
in  the  case  of  the  nervous  and  bony  tissues.  Given  for 
a  considerable  length  of  time  in  small  doses  it  affects 
the  structure  of  bone,  and  makes  the  spongy  portion 
firm  and  compact.  The  heart  is  stimulated  by  medici- 
nal doses  of  phosphorus,  and  the  temperature  slightly 
raised. 

Full  doses  given  for  a  long  time  disturb  the  stomach, 
producing  eructations  of  gas  (phosphide  of  hydrogen), 
and  depress  the  heart.  Perspiration  and  urine  are  in- 
creased by  phosphorus,  and  the  latter  becomes  reddish 
and  has  the  odor  of  violets. 

Phosphorus  poisoning  causes  grave  changes  in  met- 
abolism, indicated  by  lessened  oxidation,  and  fatty  de- 
generation in  all  the  tissues  of  the  body  and  cirrhosis 
of  the  various  organs,  stomach,  liver,  and  kidneys,  as 
well  as  necrosis  of  bone,  especially  of  the  jaw. 

Phosphorus  is  an  irritant  poison,  and  the  symptoms 
vary  somewhat  according  to  the  state  in  which  it  is 
taken,  appearing  more  quickly  after  taking  a  solution 
in  oil,  or  the  paste  used  as  a  vermin  killer,  than  after 
match  heads  or  ordinary  phosphorus  have  been  used. 
In  the  latter  case  the  symptoms  do  not  come  on  at  once; 
some  hours  usually — sometimes  one  or  two  days — in- 
tervening before  they  show  themselves.  Then  epigas- 
tric pain  and  burning  begin,  with  a  burning  sensation 
in  the  throat,  a  taste  of  garlic  in  the  mouth,  and  an 
odor  of  garlic  to  the  breath;  great  thirst,  nausea,  and 
vomiting.  During  the  first  eight  or  ten  hours  the 
vomited  matters  have  a  garlic  odor  and  are  luminous 


96  MATERIA  MEDIC  A  FOR  NURSES. 

in  the  dark,  and  if  purging  occurs,  the  faecal  matters 
are  sometimes  luminous,  as  is  also  the  urine.  Vomit- 
ing sometimes  continues  through  the  whole  of  the 
attack,  but  usually  stops  about  the  second  or  third  day. 
Jaundice  is  a  characteristic  but  not  an  invariable 
symptom.  It  appears  from  the  third  to  the  fifth  day, 
and  with  it  vomiting  may  reappear,  exuded  blood 
giving  a  peculiar  appearance  which  is  described  as 
"  coffee-ground."  There  is  great  prostration,  with  a 
small,  frequent,  almost  imperceptible  pulse,  and  cold 
skin.  The  mind  may  remain  clear,  or  there  may  be 
noisy  delirium.  Sometimes  convulsions  occur,  or 
paralysis.  Death  may  take  place  suddenly  from  col- 
lapse and  paralysis  of  the  heart,  but  more  commonly 
the  patient  dies  comatose  from  gradual  failure  of  res- 
piration and  circulation.  The  time  at  which  death 
occurs  varies  from  a  few  hours  to  several  weeks,  the 
average  time  being  several  days  or  a  week. 

The  fatal  dose  is  stated  to  be  between  gr.  f  and  ii., 
though  it  may  vary  according  to  circumstances,  and 
large  quantities  have  been  recovered  from. 

Treatment  of  Poisoning. 

The  chemical  antidote  is  the  crude  French  acid  tur- 
pentine, which  is  given  in  doses  of  3  ss.  every  fifteen 
minutes.  After  the  poison  has  entered  the  blood  there 
is  no  known  antidote,  and  therefore  emetics  and  purga- 
tives are  of  the  greatest  importance.  Sulphate  of 
copper  is  the  emetic  used,  and  forms  an  insoluble  com- 
pound, phosphide  of  copper.  It  is  given  in  dilute  solu- 
tion, gr.  ii.  at  a  time,  every  five  minutes  until  vomiting 
is  caused,  and  after  that  in  small  doses,  gr.  \,  every 
twenty  minutes  as  long  as  ordered.  Hydrated  mag- 
nesia may  be  used  as  a  purgative.  Mucilaginous  and 
albuminous  drinks  are  given,  and  all  oils  and  fats  care- 
fully avoided,  both  in  medicine  and  nourishment,  as 
they  dissolve  phosphorus  and  hasten  its  absorption. 

Chronic  phosphorus  poisoning  is  found  among  arti- 
sans who  are  exposed  to  the  fumes,  and  is  especially 


NON-METALLIC  ELEMENTS.  97 

characterized  by  necrosis  of  the  jaw.  This  form  of 
poisoning  is  not  as  common  now,  since  improved  ways 
of  making  matches  have  been  introduced,  as  it  once 
was. 

Preparations  of  Phosphorus. 

Pilulae  Phosphori. 
Pills  of  Phosphorus. 

Each  contains  gr.  T  j¥  of  phosphorus.     (0.0006  Gm.) 

Calcii      j  Hypophosphis.  Calcium      )  Hypophosphitc. 

Potassii  j  Potassium  j 

Average  dose  of  each,  gr.  viii.-o.5  Gm. 
Sodii  Hypophosphis.  Sodium  Hypophosphite. 

Average  dose,  gr.  xv.-i  Gm. 

Syrupus  Hypophosphitum. 
Syrup  of  Hypophosphites. 

Contains  hypophosphite  of  lime,  about  gr.  iii.  to 
3  i.,  and  of  soda  and  potash  each  about  gr.  i.  to 
3  i.,  with  diluted  hypophosphorous  acid,  glycerine, 
and  sugar. 

Average  dose,  3  iiss.-io  mils,  diluted. 

Chlorum  (Chlorine). 

Chlorine  is  a  greenish-yellow  gas,  belonging  to  the 
halogen  group  of  elements.  The  title  "  halogen  "  is 
derived  from  the  Greek  word  meaning  sea,  and  is  so 
given  because  the  most  important  members  of  the  group 
are  obtained  directly  or  indirectly  from  the  ocean — viz. : 
chlorine,  obtained  from  sea-salt;  bromine,  from  sea- 
water;  and  iodine,  from  sea-weed. 

Chlorine  itself  is  not  official,  but  is  represented  in 
medicine  by  several  of  its  compounds;  also  by  hydro- 
chloric acid  and  chlorinated  lime,  by  which  it  is 
furnished.  Chlorine  is  irrespirable,  and  of  strong 
penetrating  odor.  It  is  soluble  in  water,  in  the  propor- 
tion of  two  parts  gas  to  one  Dart  water.  If  inhaled  in 

7 


98  MATERIA  MEDIC  A  FOR  NURSES. 

any  quantity  it  irritates  the  lining  of  the  air-passages, 
causes  spasm  of  the  glottis,  and  narcotizes  the  brain. 

It  is  a  most  powerful  disinfectant,  antiseptic,  and 
deodorant,  its  great  activity  in  these  respects  being 
due  to  its  affinity  for  hydrogen,  by  which  it  decom- 
poses compounds  containing  hydrogen,  and  sets  oxygen 
free  in  its  most  active  state,  as  ozone.  It  is  not  used 
in  disinfecting  clothing,  as  it  destroys  the  color  and 
texture  of  fabrics,  nor  the  person,  as  it  cannot  be 
breathed  in  a  strength  sufficient  to  destroy  germs. 
For  disinfecting  rooms  it  may  be  prepared  as  follows: 
Mix  equal  parts  of  common  salt  and  black  oxide  of 
manganese.  To  a  tablespoonful  of  this  powder,  in  a 
saucer,  add  a  tablespoonful  (  |  ss.)  of  strong  sulphuric 
acid  diluted  one  third  with  water.  In  cold  weather  the 
saucer  should  be  heated.  This  will  produce  enough 
chlorine  to  disinfect  a  room  thirty-two  feet  square. 

Calx  Chlorinata. 
Chlorinated  Lime. 

Made  by  the  action  of  chlorine  on  slaked  lime,  con- 
taining 30  per  cent,  chlorine.  Its  action  as  a  disin- 
fectant is  that  of  chlorine,  and  when  so  used  it  should 
be  perfectly  fresh  or  it  is  valueless.  To  test  it,  dissolve 
a  little  in  water;  if  the  solution  is  clear  it  is  good,  but 
if  it  has  lost  its  chlorine  the  solution  will  be  turbid 
and  milky.  This  preparation  is  popularly  called 
chloride  of  lime. 

Liquor  Sodas  Cfclorinatae. 
Solution  of  Chlorinated  Soda. 

Labarraque'3  Solution. 

Contains  sodium  carbonate  and  chlorinated  lime.  A 
greenish-yellow  liquid,  with  sharp  salty  taste  and  very 
slight  odor  of  chlorine.  It  is  a  good  preparation  for 
cleansing  purposes  in  sick-rooms,  wards,  etc.,  in  weak 
solution.  In  full  strength  it  removes  stains  from  glass. 
Medicine  droppers,  douche  nozzles,  and  other  small 
articles  which  are  hard  to  clean  may  be  soaked  in  it 
until  the  stains  come  away. 


NON-METALLIC  ELEMENTS.  99 

The  antidote,  in  case  of  poisoning  by  any  of  the 
chlorine  compounds,  is  albumin:  white  of  egg,  milk 
and  flour. 

Bromum,  (Bromine.) 

A  liquid  element  obtained  from  sea-water  and  from 
certain  mineral  springs.  A  dark,  brownish-red,  very 
volatile  liquid,  of  strong  and  suffocating  odor.  When 
brought  into  contact  with  organic  matter  it  oxidizes 
and  destroys  it  with  great  rapidity.  Its  local  action 
is,  therefore,  powerfully  irritant  and  escharotic.  It 
is  also  a  deodorant  and  antiseptic.  It  is  never  given 
internally,  alone,  but  has  been  used  as  a  caustic,  and 
the  vapor  has  been  used  medicinally. 

Preparations  of  Bromine. 

Potassii  Bromidum. 
Potassium  Bromide. 

Prepared  by  adding  a  solution  of  pure  carbonate  of 
potash  to  a  solution  of  bromide  of  iron,  filtering,  and 
evaporating.  Colorless  crystals,  soluble  in  i^  parts 
water. 

Physiological  Actions. 

Potassium  bromide  lessens  cerebral  activity,  and  the 
tendency  to  "  emotionalism";  diminishes  the  sensibil- 
ity and  irritability  of  the  mind  in  various  nervous  states; 
such,  for  instance,  as  result  from  excessive  mental 
strain,  anxiety,  or  intellectual  work;  and  produces  a 
condition  of  anaemia  of  the  brain  such  as  is  found  in 
natural  sleep.  It  is  thus  an  indirect  hypnotic,  not 
acting  like  opium  or  chloral,  but  inducing  sleep  by 
bringing  about  a  physiological  condition  favorable  to 
its  advent.  Bromide  of  potash  is  depressing  to  the 
heart  and  respirations,  both  being  slowed  and  weak- 
ened by  its  action.  The  spinal  centres,  spinal  nerves, 
and  the  muscles  are  all  -depressed,  and  the  tempera- 


100  MATERIA  MEDIC  A  FOR  NURSES. 

ture  somewhat  lowered,  though  not  to  any  marked 
extent.    Bromide  of  potassium  contains  66  per  cent,  of 
bromine. 
Dose,  gr.  x.-xx.     (0.65-1.3  Gm.) 

Ammonii  Bromidum. 
Ammonium  Bromide. 

Prepared  by  precipitating  the  freshly  made  solution 
of  bromide  of  iron  with  ammonia  water.  The  salt  re- 
maining in  solution  is  crystallized  and  powdered.  It 
is  soluble  in  i^  parts  of  water.  The  effects  and  uses  of 
bromide  of  ammonia  are  very  like  those  of  the  bromide 
of  potash,  and  it  is  said  to  be,  in  addition,  slightly 
stimulating.  It  is  not  much  used. 

Average  dose,  gr.  xv.-i  Gm, 

Sodii  Bromidum 
Sodium  Bromide. 

Colorless  crystals,  soluble  in  iii>  parts  of  water,  and 
containing  98  per  cent,  of  sodium  bromide.  It  resembles 
potassium  bromide,  and  has  very  much  the  same  quali- 
ties. It  is  considered  less  depressing,  and  the  least 
toxic  of  all  the  bromide  preparations.  There  is  a 
variety  of  opinions  as  to  its  hypnotic  power  compared 
with  that  of  potassium  bromide. 

Average  dose,  gr.  xv.-i  Gm. 

Lithii  Bromidum. 
Lithium  Bromide. 

A  granular,  very  soluble  salt,  containing  98  per  cent, 
of  lithium  bromide.  In  addition  to  the  hypnotic  power 
of  the  bromides  in  general  it  is  said  to  have  some  tonic 
and  diuretic  action. 

Average  dose,  gr.  xv.-i  Gm. 

Incidental  Effects. 

In  giving  a  course  of  the  bromides  it  is  very  essential 
that  the  state  of  the  digestion  and  of  the  bowels  be 


NON-METALLIC  ELEMENTS.  IOI 

carefully  watched,  and  the  latter  strictly  regulated,  foi 
the  accumulation  of  an  excess  of  bromine  in  the  system 
causes  a  series  of  symptoms  known  as  "bromism." 
The  first  is  usually  a  salty  taste  in  the  mouth,  with 
salivation  and  fetid  breath.  Next  come  drowsiness, 
heaviness,  and  sluggishness  of  intellect,  loss  of  mem- 
ory, partial  aphasia,  depressed  spirits,  a  staggering 
gait,  dull,  listless  expression,  sluggish  pupils,  and 
sometimes  an  infrequency  of  winking. 

One  of  the  marked  features  of  bromism  is  the  appear- 
ance of  eruptions  of  the  skin,  in  great  variety,  and  of 
varying  severity.  All  manner  of  skin  lesions  have 
been  described  as  resulting  from  the  use  of  bromine, 
even  to  one  resembling  that  of  smallpox.  The  most 
common  is  a  simple  acne  or  eruption  of  pimples.  It 
sometimes  occurs  early,  or  after  the  use  of  small  doses, 
yet  is  not  always  among  the  first  symptoms. 

The  bromides  are  excreted  by  the  kidneys  chiefly, 
also  by  the  salivary  and  mammary  glands,  the  skin, 
and  all  mucous  surfaces.  They  are  rapidly  diffused, 
appearing  in  the  secretions  a  few  moments  after  being 
taken. 

lodum  (Iodine). 

Iodine  is  a  non-metallic  element  of  bluish  color, 
derived  chiefly  from  the  ashes  of  sea- weeds;  not  read- 
ily soluble  in  water;  soluble  in  ether,  alcohol,  and 
glycerin.  It  is  never  given  internally  in  crude  form. 

Physiological  Actions. 

Applied  externally  iodine  is  an  irritant  and  vesi- 
cant, and  stains  the  skin  yellow,  or,  in  repeated  appli- 
cations, deep  brown.  It  causes  some  pain,  with  a 
feeling  of  warmth,  and  desquamation  may  follow  its 
use.  It  is  absorbed  into  the  blood  partly  through  the 
skin  and  partly  in  the  form  of  vapor. 

The  vapor  of  iodine,  like  that  of  chlorine,  but  in  a 
feebler  degree,  decomposes  sulphuretted  and  phosphu- 
retted  compounds,  and  is,  therefore,  antiseptic  and 


102  MATERIA  MEDIC  A  FOR  NURSES. 

disinfectant.  Internally  iodine  excites  a  sensation  of 
heat  and  burning  in  the  stomach.  In  sufficient  quan- 
tity it  is  an  irritant  poison,  causing  inflammation  of  the 
lining  of  the  stomach,  severe  pain  in  the  abdomen, 
vomiting,  and  purging.  The  matters  vomited  have  a 
yellow  color,  except  when  farinaceous  food  has  been 
taken;  in  this  case  they  are  blue  or  purplish.  The 
amount  of  iodine  necessary  to  produce  toxic  symptoms 
varies  with  constitutional  peculiarities  and  with  the 
kind  and  amount  of  food  in  the  stomach.  Death  has 
been  caused  in  twenty-four  hours  by  3  i.  The  antidote 
is  starch  or  flour  stirred  up  in  water,  and  emetics  should 
be  given  afterwards. 

Iodine  is  rapidly  excreted,  appearing  in  the  urine, 
the  perspiration,  saliva,  bile,  milk,  and  mucous  secre- 
tions, especially  of  the  air-passages. 

Preparations  of  Iodine. 

Potassii  lodidum. 
Potassium  Iodide. 

Made  by  dissolving  iodine  in  liquor  potassse,  evapo- 
rating, and  treating  the  residue  with  wood  charcoal. 

Potassium  iodide  is  extremely  diffusible  and  enters 
the  blood  with  great  rapidity.  It  acts  in  a  general 
way  as  a  tonic  and  stimulant  to  nutrition,  accelerates 
tissue-changes,  and  increases  the  excretion  of  waste 

Eroducts.     It  has  some   slight  diuretic  action,  and 
as  the  power  of  dislodging   from   the  tissues  vari- 
ous poisonous  metallic  substances,  notably  lead  and 
mercury. 

The  lymphatic  glands  are  reduced  in  size  by  iodide 
of  potash,  and,  like  mercury,  it  has  over  some  forms  of 
disease  a  marked  and  positive  influence,  not  thoroughly 
explainable.  Its  action  in  these  cases  is  called  "  spe- 
cific "  or  "  alterative." 

Incidental  Effects. 

In  giving  any  of  the  iodides,  and  especially  the  iodide 
of  potash,  the  peculiar  set  of  symptoms  known  as 


NON-METALLIC  ELEMENTS.  103 

"iodism"  must  be  carefully  watched  for.  There  is 
first  an  inflammation  of  the  mucous  membrane  of  the 
head  resembling  acute  coryza,  or  catarrh;  running  at 
the  eyes  and  nose,  salivation,  swelling  of  the  eyelids, 
sneezing,  and  frontal  headaches;  sore-throat,  hoarse- 
ness, and  trouble  in  swallowing,  with  a  feeling  of  gen- 
eral wretchedness,  and  rise  in  temperature. 

There  are  also  several  varieties  of  eruptions  which 
may  appear,  said  to  be  more  likely  to  occur  in  the  case 
of  patients  with  diseased  kidneys.  The  most  common 
is  an  eruption  of  acne  on  the  face,  shoulders,  and 
thighs,  and  eczema  is  also  frequent. 

Debility  and  pains  in  the  joints  are  sometimes 
noticed,  and  in  some  cases  digestive  disturbances 
result,  with  nausea  and  diarrhoea. 

The  solution  of  i  in  i  (fll  i.  =  gr.  i.)  is  best  given 
in  milk;  or  it  may  be  given  in  cinnamon  water,  or  the 
compound  syrup  of  sarsaparilla,  to  disguise  the  un- 
pleasant taste.  It  is  often  ordered  with  bichloride  of 
mercury,  and  they  may  be  given  together,  but  if  it  is 
not  ordered  in  combination  it  should  never  be  added  to 
any  other  medicine,  but  given  alone. 

By  largely  diluting  it  and  giving  it  on  an  empty 
stomach,  symptoms  of  iodism  are  in  a  measure  avoided. 

Potassium  iodide  is  given  pleasantly  and  with  great 
freedom  in  aromatic  spirits  of  ammonia. 

Average  dose,  gr.  v.-o.3  Gm. 

Liquor  lodi  Compositus. 
Compound  Solution  of  Iodine. 
Lugol's  Solution. 

Composed  of  iodine  and  potassium  iodide — of  the 
former,  5%. 

Average  dose,  TTJ,  iii.-o.2  mil,  well  diluted. 

Tinctura  lodi. 
Tincture  of  Iodine. 

Contains  70  Gm.  iodine,  and  50  Gm.  potassium 
iodide,  in  1000  mils  alcohol. 


104  MATERIA   MEDIC  A    FOR  NURSES. 

Recent  surgical  work  has  given  the  iodine  tincture 
a  distinguished  place  in  the  technique  of  disinfection 
and  treatment  of  wounds.  It  was  formerly  used  simply 
as  a  counterirritant,  painted  on  the  skin  as  ordered, 
with  a  camel's-hair  brush.  If  the  application  is  pain- 
ful and  it  is  desirable  to  remove  it,  a  weak  solution  of 
ammonia  will  take  it  off. 

Unguentum  lodi. 
Iodine  Ointment. 

Contains  4  parts  in  100  of  iodine,  with  4  parts  of 
potassium  iodide,  12  parts  glycerine,  and  benzoinated 
lard  to  make  up  the  rest. 

lodoformum. 
lodoform. 

lodoform  is  made  by  heating  iodine  with  potassium 
carbonate,  alcohol,  and  water,  and  allowing  the  crys- 
talline deposit  to  settle.  It  consists  of  small,  bright- 
yellow,  lustrous  crystalline  scales,  with  a  very  strong 
and  clinging  odor,  and  sweetish  taste.  It  contains 
about  97  per  cent,  of  iodine,  and  is  freely  soluble  in 
oils,  ether,  and  chloroform.  It  is  slightly  volatile  at 
ordinary  temperatures,  and  at  a  temperature  above 
239°  F.  emits  vapors  of  iodine. 

lodoform  was  discovered  in  1822,  but  was  not  used 
for  some  years.  Before  the  perfecting  of  surgical  tech- 
nique it  had  great  vogue  for  a  time  as  a  disinfectant 
and  antiseptic.  lodoform  gauze  was  much  used  for 
wounds  and  dressings,  and  the  powder  freely  applied. 
This  overuse  caused  many  cases  of  poisoning,  as  it  is 
absorbed  with  great  facility  through  an  abraded  surface. 


NON-METALLIC  ELEMENTS.  105 

Such  incidents  checked  its  popularity,  and  its  strong 
odor  made  patients  averse  to  it. 

As  sterilization  developed  and  other  substances  were 
evolved,  the  use  of  iodoform  was  diminished.  In  cases 
of  poisoning  by  absorption  through  a  wounded  surface, 
the  following  symptoms  may  occur: 

Rise  of  temperature  as  high  as  104°  F.,  or  higher* 
This  may  be  the  only  symptom;  or  with  it  there  may 
be  headache,  a  rapid  and  compressible  pulse,  and  loss 
of  appetite,  the  symptoms  going  off  as  soon  as  the 
iodoform  is  discontinued.  Iodine  is  found  in  the  urine 
in  iodoform  poisoning.  More  serious  effects  are:  a 
grave  depression  of  the  system,  and  anxious  melan- 
cholia; a  restless  mental  condition,  with  very  weak  and 
rapid  pulse,  perhaps  reaching  180;  drowsiness,  delirium, 
and  collapse.  Death  sometimes  occurs  quickly,  even 
though  the  application  be  stopped.  The  amount  cap- 
able of  causing  fatal  poisoning  has  been  recorded  as 
varying  from  500  grains  upwards.  In  using  iodoform 
the  extent  of  exposed  surface  through  which  absorption 
may  take  place  is  of  more  importance  than  the  actual 
amount  applied,  which  may  not  all  be  absorbed. 

Iodoform  is  sometimes  given  internally,  in  pill  or 
capsule.  Average  dose,  gr.  ii.— 0.125  Gm. 

Unguentum  lodoformi. 
Iodoform  Ointment. 

Iodoform  10  parts,  and  benzoinated  lard  90  parts. 

lodolum. 
lodol. 

lodol  is  an  unofficial  substance  which  has  been 
produced  in  the  attempt  to  make  an  equivalent  for 
iodoform,  which  should  have  its  qualities  without  the 
unpleasant  odor.  It  is  obtained  by  the  action  of  iodine 
on  certain  constituents  of  mineral  oil,  and  contains 
about  85  per  cent,  iodine.  It  is  a  yellowish-brown 


106  MATERIA  MEDICA  FOR  NURSES. 

powder,  which  darkens  on  exposure  to  light.  It  is 
odorless,  soluble  in  alcohol,  ether,  and  chloroform;  in- 
soluble in  waiter.  It  is  said  to  be  as  efficiently  anti- 
septic and  disinfectant  as  iodoform,  having  the  same 
deodorant  and  anaesthetic  properties,  but  it  is  not 
much  used. 

Other  derivatives  of  iodoform,  unofficial,  are : 

Aristol.  Antiseptin. 

Europhen.  Losophane. 

Antiseptol.  Sozoiodol. 

Sozal.  SuJphaminol. 
Thiophene. 

Sulphur  (Brimstone). 

Sulphur  is  found  native  in  volcanic  districts  as 
crude  sulphur,  and  in  combination  with  metals,  as 
sulphides.  Not  official  as  crude  sulphur. 

Physiological  Actions. 

Sulphur  is  used  externally  for  its  action  on  the  skin. 
It  has  no  local  action  of  its  own,  but  by  contact  with 
the  products  of  the  skin  it  changes  into  sulphuretted 
hydrogen  and  sulphides,  which  are  active  substances. 
In  this  form  it  is  a  vascular  stimulant,  a  nerve 
sedative,  a  stimulant  to  the  skin,  and  a  diaphoretic. 

Taken  internally  it  acts  as  a  laxative,  increasing 
peristalsis,  and  it  has  also  probably  some  power  of 
influencing  nutrition. 

If  taken  for  a  long  time  it  impairs  the  blood  and 
causes  emaciation,  anaemia,  trembling,  and  debility.  It 
forms  sulphuretted  hydrogen  in  the  intestines,  giving 
an  unpleasant  odor  to  the  fseces,  and  the  same  dis- 
agreeable odor  is  imparted  to  the  perspiration,  by  the 
excretion  of  sulphur  through  the  skin.  Silver  jewelry 
worn  by  a  patient  taking  sulphur  becomes  discolored 
by  the  excretions  of  the  skin. 


NON-METALLIC  ELEMENTS.  IO/ 

Preparations  of  Sulphur. 

Sulphur  Sublimatum. 
Sublimed  Sulphur. 
Flowers  of  Sulphur. 

Prepared  from  crude  sulphur  (which  compressed  into 
molds  forms  the  roll  sulphur  used  in  fumigating)  by 
subliming.  A  yellow  powder,  tasteless,  and  odorless 
until  heated,  and  insoluble  in  water.  It  always  con- 
tains a  little  sulphuric  acid,  and  is  used  only  in  making 
other  preparations. 

Sulphur  Lotum. 
Washed  Sulphur. 

Sublimed  sulphur  washed  with  ammonia  water  and 
freed  from  acid.     The  action  is  laxative.     It  is  given 
in  powder  mixed  with  simple  syrup  or  molasses.    Dose, 
3  i-~4  Gm.,  given  at  night. 

Potassa  Sulphurata. 
Liver  of  Sulphur. 

A  mixture  containing  about  12  per  cent,  of  sul- 
phur. Solid  greenish  pieces,  alkaline,  and  of  very 
acrid  taste;  soluble  in  water,  making  an  orange-colored 
solution.  Locally  applied,  sulphurated  potash  is  an 
irritant,  and  taken  internally  is  a  violent  corrosive 
poison.  It  is  used  in  ointments  and  in  giving  sulphur 
baths;  in  the  latter  case  in  a  strength  of  from  3  i.-vi.  to 
30  gallons  of  water.  The  bath  may  last  from  twenty 
minutes  to  two  hours,  and  has  a  generally  stimulat- 
ing effect. 

A  papular  eruption  and  eczema  sometimes  follow  the 
use  of  sulphur. 

Unguentum  Sulphuris. 
Sulphur  Ointment. 

Sulphur  in  strength  of  1}  parts  in  10,  with  benzoin 
ated  lard. 


108  MATERIA  MED  1C  A  FOR  NURSES. 

Ichthyol.    Not  official. 

A  preparation  obtained  from  a  bitumen  !  found  in  the 
Tyrol,  and  supposed  to  be  the  residue  of  extinct  fishes. 
It  contains  10  per  cent,  of  sulphur  and  is  not  irritating 
to  the  skin.  It  is  used  externally  in  an  ointment  of 
10-20  per  cent,  strength.  It  is  useful  as  a  sedative, 
antiseptic,  and  alterative. 

Carbo  Ligni. 
Wood  Charcoal. 

Charcoal  is  obtained  from  the  combustion  of  bones, 
— carbo  animalis,  animal  charcoal,  or  bone  black — and 
of  wood — carbo  ligni,  wood  charcoal. 

Charcoal  absorbs  and  condenses  many  gases  and 
vapors,  coloring  matters,  alkaloids,  and  other  sub- 
stances in  quantities  many  times  greater  than  its  own 
bulk;  and  when  exposed  to  the  air  it  thus  increases 
rapidly  in  weight.  For  this  reason,  when  intended  for 
medicinal  purposes  it  must  be  kept  carefully  covered  in 
well-stoppered  bottles. 

Externally  it  is  used  as  an  absorbent  and  deodo- 
rant, and  internally  as  a  carminative.  It  may  be 
given  between  two  slices  of  bread  and  butter,  or  mixed 
with  wine.  Charcoal  does  not  enter  the  system,  but  is 
entirely  expelled  by  the  bowels.  Average  dose,  gr.  xv.- 
i  Gm. 

Liquor  Hydrogenii  Dioxidi. 
Solution  of  Hydrogen  Dioxide. 
Solution  of  Hydrogen  Peroxide. 

A  slightly  acid  watery  solution  of  hydrogen  dioxide, 
containing,  when  fresh,  about  3  per  cent.,  by  weight, 
of  the  pure  dioxide,  corresponding  to  about  ten  volumes 
of  oxygen. 

It  is  used  in  the  treatment  of  ulcers,  fetid  suppura- 

1  An  inflammable  mineral  substance. 


INORGA  NIC  A  CIDS.  109 

tion,  diphtheritic  membranes,  etc.  Its  virtues  depend 
on  its  readiness  to  yield  0x3' gen  to  all  oxidizable  sub- 
stances. 

As  it  soon  loses  strength,  it  should  be  kept  in  small 
quantities,  in  a  cool  place,  not  exposed  to  the  light, 
and  as  it  is  an  expensive  article,  should  be  carefully 
used. 

INORGANIC  ACIDS. 

Acidum  Sulphuricum,  Sulphuric  Acid. 

(Oil  of  Vitriol.) 

Sulphuric  acid  is  made  by  passing  in  leaden  chambers 
simultaneously  the  vapors  of  burning  sulphur,  nitric 
acid,  steam,  and  air. 

It  is  a  colorless,  oily-looking,  intensely  acid  liquid, 
containing  7.5  per  cent,  water.  On  exposure  to  the  air 
it  absorbs  moisture. 

Physiological  Actions. 

Sulphuric  acid  is  a  powerful  corrosive,  and  ab- 
stracts water  from  animal  and  vegetable  tissue,  leaving 
carbon.  It  thus  blackens  organic  matter  while  destroy- 
ing its  texture. 

Concentrated  and  mixed  in  a  paste  with  charcoal, 
sulphuric  acid  has  been  used  as  an  escharotic.  Di- 
luted, its  special  action  both  externally  and  internally 
is  that  of  an  astringent. 

Symptoms  of  Poisoning. 

When  swallowed  in  concentrated  form  it  corrodes  the 
alimentary  canal,  causing  acute  pain  of  the  mouth, 
throat,  and  epigastrium.  The  tongue  and  lining  of  the 
mouth  are  whitened,  like  parchment,  afterwards  turn- 
ing brown,  while  brown  or  blackened  spots  appear  on 
the  lips. 

There  are:  violent  vomiting,  of  tarry  matters  often, 


1 10'  MATERIA  MEDICA  FOR  NURSES. 

cold  extremities,  and  clammy  skin;  proiuse  and  bloody 
salivation,  suppressed  voice,  and  feeble  pulse.  The 
face  expresses  great  suffering  and  anxiety.  The  mind 
is  clear.  The  matters  at  first  vomited  are  acid,  and  if 
they  fall  on  colored  articles  of  dress  the  color  is  taken 
out  and  the  texture  destroyed;  while  on  black  material 
brown  spots  are  produced,  with  an  edge  of  red. 

There  is  sometimes  perforation  of  the  stomach  or  in- 
testines. The  symptoms  come  on  immediately  after 
the  act  of  swallowing,  and  death  may  result  in  a  few 
hours,  but  usually  delays  for  from  18  to  24  hours; 
occurring,  finally,  very  suddenly.  The  smallest  fatal 
dose  recorded  is  3  i.  Usually  §  i.  or  more  has  been 
taken. 

Antidotes. 

The  antidotes  are  chalk,  magnesia,  whitewash,  or 
soap.  They  should  be  mixed  in  milk  or  water  and 
given  freely. 

Preparations. 

Acidum  Sulphuricum  Dilutum. 
Diluted  Sulphuric  Acid. 

Has  a  strength  of  10  per  cent,  of  the  acid. 
Average  dose,  TU  xv.-i  mil. 

Acidum  Sulphuricum  Aromaticum. 
Aromatic  Sulphuric  Acid. 

Contains  alcohol  and  aromatics,  and  acid  in  a  strength 
of  20  per  cent.  Both  these  preparations  should  be  given 
well  diluted,  and  through  a  glass  tube,  to  save  the 
teeth  from  injury. 

Average  dose,  fi\,  xv.-i  mil. 

Acidum  Nitricum,  Nitric  Acid. 
(Aqua  Fortis.) 

Nitric  acid  is  prepared  from  nitre  by  distillation  with 
water  and  sulphuric  acid.  A  colorless,  intensely  acid, 


INORGA  NIC  A  CIDS.  Ill 

fuming  liquid,  containing  68  per  cent,  acid,  the  rest 
water. 

Physiological  Actions. 

It  is  a  very  powerful  caustic,  and  if  used  in  this  way 
the  sound  tissues  should  be  protected  by  a  coating  of 
oil  or  soap,  or  sheet-lint  wet  in  a  solution  of  bicarbo- 
nate of  soda,  and  the  spot  cauterized  be  washed  with 
warm  soap-suds  after  sufficient  effect  has  been  obtained. 

Taken  internally  in  medicinal  doses  it  has  stimulant 
and  astringent  properties. 

Poisoning  and  Antidotes. 

In  concentrated  form  nitric  acid  is  an  exceedingly 
corrosive  poison,  even  more  violent  than  sulphuric 
acid.  Like  the  latter,  it  destroys  the  membrane  lining 
of  the  mouth,  oesophagus,  and  stomach.  The  symp- 
toms are  the  same,  except  that  nitric  acid  stains  the 
tissues  yellow  instead  of  black.  They  come  on  with 
the  same  severity,  and  immediately.  The  antidotes 
are  the  same,  and  death  occurs  on  an  average  in  half  a 
day,  or  a  day. 

Preparations. 

Nitric  Acid  is  used  in  preparing  Acidum  Nitro- 
hydrochloricum  in  its  strong  and  diluted  forms.  There 
is  no  longer  an  official  preparation  of  diluted  nitric  acid 
for  medicinal  use. 

Acidum  Hydrochloricum. 
Hydrochloric  (Muriatic)  Acid. 

Hydrochloric  acid  is  obtained  by  the  action  of  sul- 
phuric acid  on  chloride  of  sodium,  and  solution  of  the 
fumes  in  water  until  it  has  a  strength  of  about  31  per 
cent.  An  almost  colorless,  very  acid  liquid,  with  pun- 
gent odor.  It  is  one  of  the  natural  acids  of  the  stomach, 


112  MATERIA  MEDIC  A  FOR  NURSES. 

and  acts  as  a  tonic  on  the  glands  of  the  alimentary 
canal,  increasing  the  normal  secretions.  Its  astringent 
properties  are  not  marked.  In  concentrated  form  it  is 
a  corrosive  poison,  not  as  powerful  as  nitric  or  sulphuric 
acids.  The  symptoms  and  treatment  are  like  the  other 
two. 

Acidum  Hydrochloricum  Dilutum. 

Diluted  Hydrochloric  Acid. 

Has  a  strength  of  about  10  per  cent. 
Average  dose,  Til  xv.-i  mil,  well  diluted  and  given 
after  meals. 

Acidum  Nitrohydrochloricum. 
Nitrohydrochloric  Acid. 

Made  by  mixing  180  parts  of  nitric  with  820  parts  of 
hydrochloric  acid.  An  orange-colored  liquid,  chang- 
ing color  in  time,  and  more  rapidly  on  exposure  to 
light,  to  a  light  yellow.  In  medicinal  doses  the  physio- 
logical effects  are:  stimulation  of  the  liver  especially, 
and  also  of  the  other  glands  of  the  alimentary  canal. 
Besides  being  given  internally,  it  is  used  in  local  appli- 
cations over  the  liver,  and  in  baths.  In  the  former  case, 
for  stupes,  the  strength  is  3  i.-iii.  to  O.  i.  of  water;  and 
in  the  latter,  §  i.  to  C.  i.  In  poisonous  doses  the  effects 
are  the  same  as  the  other  mineral  acids.  The  stains  it 
produces  are  yellow.  The  same  antidotes  are  used  as 
given  before. 

In  giving  any  of  the  mineral  acids,  the  first  symp- 
toms of  intolerance  are:  griping  pains  and  diarrhoea, 
with  strongly  acid  urine.  These  points  are  to  be  re- 
membered, as  well  as  the  necessity  for  protecting  the 
teeth. 

Acidum  Nitrohydrochloricum  Dilutum. 
Diluted  Nitrohydrochloric  Acid. 

Average  dose,  Ti|  x.-o.65  mil,  well  diluted  and  given 
through  a  glass  tube. 


INORGA  NIC  A  CIDS.  113 

Acidum  Phosphoricum,  Phosphoric  Acid. 

A  colorless,  odorless  liquid,  made  by  boiling  phos- 
phorus with  nitric  acid  and  water,  and  having  a  strength 
of  85  per  cent.  It  is  very  acid,  but  does  not  corrode 
the  tissues.  Its  physiological  effects  are  unimportant 
—mildly  tonic  and  astringent. 

Acidum  Phosphoricum  Dilutum. 
Diluted  Phosphoric  Acid. 

Dose,  TH,  xxx.-2  mils,  well  diluted. 

Acidum  Sulphurosum,  Sulphurous  Acid. 

Made  by  heating  sulphuric  acid  with  charcoal.  Sul- 
phurous-acid gas  results,  and  is  dissolved  in  water, 
constituting  6  per  cent,  of  the  solution.  A  colorless 
liquid  with  pungent  sulphurous  odor.  Sulphurous-acid 
gas  6.4  per  cent,  is  obtained  by  the  combustion  of  roll 
sulphur,  and  was  formerly  used  in  disinfecting  rooms. 
This  form  of  disinfection,  formerly  believed  to  be  ef- 
ficient, is  now  known  to  be  useless  in  so  far  as  patho- 
genic bacteria  are  concerned,  and  boards  of  health  are 
abandoning  its  use  after  contagious  disease,  though  no 
faster  than  the  advance  in  popular  education  on  such 
lines.  It  is,  however,  of  real  value  in  ridding  a  room 
or  ward  of  bedbugs,  if  these  pests  have  lodged  in  the 
walls  or  woodwork,  and  for  this  purpose  steam  is  not 
necessary.  It  is  a  specific  for  all  forms  of  lower  animal 
life — not  bacteria. 

Acidum  Boricum,  Boric  Acid. 

Made  by  the  action  of  sulphuric  acid  on  borax,  or  by 
purification  of  native  boric  acid,  which  is  a  compound 
of  the  element  boron  with  oxygen,  and  is  obtained  from 
certain  mineral  springs  in  Italy.  White,  pearly,  glis- 
tening crystals,  soluble  in  25  parts  of  cold  and  3  parts 


114  MATERIA  MEDIC  A  FOR  NURSES. 

of  hot  water.     The  saturated  solution  has  a  strength 
of  4  per  cent. 

Physiological  Actions. 

Boric  acid  is  antiseptic,  disinfectant,  and  deodo- 
rant, destroying  low  organisms,  and  stopping  fermen- 
tation and  putrefactive  changes. 

It  is  not  irritating  externally,  but  rather  the  reverse, 
and  when  applied  to  wounds  prevents  suppuration. 
Internally,  in  large  doses,  it  is  a  gastro-intestinal 
irritant,  and  poisoning  has  been  caused  by  washing 
out  internal  cavities  with  a  5  per  cent,  solution.  The 
symptoms  were:  nausea,  vomiting,  hiccough,  disturbed 
respirations,  rapid ;  feeble  pulse  ;  erythema  and  ecchy- 
mosis,  subnormal  temperature,  and  collapse.  As  a 
wash  for  babies'  eyes  and  mouths,  the  saturated  solu- 
tion is  diluted  one  half  with  water. 

It  is  used  as  the  basis  of  a  variety  of  mouth  washes 
for  the  sick.  It  constitutes  the  largest  part  of  Thiersch 
powder,  used  in  making  an  antiseptic  solution.  (See 
salicylic  acid.)  Its  use  as  a  preservative  for  milk  is 
dangerous,  the  milk  so  preserved  being  injurious, 
especially  to  infants. 

Unguentum  Acidi  Borici. 
Ointment  of  Boric  Acid. 

Contains  paraffin,  white  petrolatum,  and  boric  add. 

THE  ORGANIC  ACIDS. 
Acidum  Aceticum,  Acetic  Acid. 

Prepared  from  wood  by  destructive  distillation  and 
purification.  A  colorless  liquid,  with  pungent  odor 
and  strong  acid  taste;  strength  36  per  cent.;  the  rest 
water. 

Glacial  acetic  acid  has  99  parts  acetic  acid  to  I  of 
water,  and  crystallizes  at  a  temperature  below  60°.  It 
is  not  official. 


THE  ORGA  NIC  A  CIDS.  1 1 5 

Acidutn  Aceticum  Dilutum. 
Diluted  Acetic  Acid. 

Has  a  strength  of  about  6  per  cent. 

Acetum. 

Vinegar.   Not  official. 

An  organic  liquid  containing  acetic  acid.  It  corre- 
sponds nearly  in  strength  with  the  dilute  acid.  Vine- 
gar is  obtained  from  various  vegetables  and  fruits  by  a 
process  of  fermentation  known  as  the  acetous  or  sour, 
as  distinguished  from  the  vinous  fermentation  and 
others. 

Acetous  fermentation  may  be  induced  in  all  liquids 
capable  of  undergoing  vinous  fermentation. 

The  best  vinegar  is  made  from  cider.  It  is  often 
adulterated  with  sulphuric  acid. 

Locally  used  acetic  acid  is  a  caustic.  It  is  best  ap- 
plied with  a  glass  rod  or  a  splinter  of  wood,  and  needs 
to  be  applied  with  care  to  avoid  injuring  the  surround- 
ing parts. 

Diluted  and  applied  to  the  skin  it  is  stimulant,  as- 
tringent, and  refrigerant,  and  in  the  form  of  vinegar 
is  sometimes  added  to  baths  for  the  reduction  of 
temperature. 

Internally  it  has  a  stimulating  effect  on  the  appetite 
and  digestion;  increases  the  secretion  frcm  the  intes- 
tines, and  the  flow  of  urine.  It  does  not  neutralize  the 
alkalinity  of  the  blood,  but  decomposes  there,  and 
combines  with  part  of  the  alkali  of  the  plasma,  forming 
a  carbonate,  and  in  this  form  passes  out  of  the  body, 
unless  given  in  excess,  when  the  excess  escapes  un- 
changed from  the  kidneys.  In  the  alimentary  canal 
the  acid  acts  directly  en  its  contents,  and  is  given  in 
the  form  of  vinegar  as  an  antidote  for  poisoning  by 
alkalies. 

In  concentrated  doses  acetic  acid  is  a  corrosive 
poison,  and  has  caused  death  in  one  case  known. 


Il6  MATERIA  MED  1C  A  FOR  NURSES. 

The  symptoms  are  like  those  of  the  mineral  acids, 
and  the  treatment  is  the  same,  consisting  in  giving 
alkalies  and  their  carbonates,  warm  soap-suds,  and 
milk. 

Acidum  Citricum,  Citric  Acid. 

Citric  acid  is  obtained  from  the  juice  of  the  lemon, 
Citrus  limonum,  or  of  the  lime,  Citrus  bergamia,  by 
neutralizing  the  boiling  juice  with  chalk,  and  putting 
it  through  various  processes.  It  is  very  soluble  in 
water,  and  gr.  xx.  in  3  ss.  of  water  makes  a  solution 
resembling  lemon  juice  in  strength  and  acidity. 

Citric  acid,  like  the  other  free  acids,  acts  directly  on 
the  contents  of  the  alimentary  canal,  neutralizing 
alkalies. 

It  is  stimulant ;  relieves  thirst  and  promotes  appe- 
tite; increases  the  flow  of  the  saliva  and  of  the  gastric 
juice,  and,  indirectly,  increases  the  action  of  the  kid- 
neys and  skin,  hot  lemonade  especially  being  a 
diaphoretic. 

It  is  slightly  laxative,  and  counteracts  a  tendency 
to  torpidity  of  the  liver.  The  juice  of  half  a  lemon, 
mixed  with  that  of  an  orange,  is  a  satisfactory  laxative 
drink  in  many  cases.  It  is  best  taken  before  breakfast. 

In  malarial  countries  letnon-j  uice  is  freely  used  as  an 
article  of  food,  and  among  sailors  and  soldiers  it  is  used 
as  a  prophylactic  against  scurvy. 

Citric  acid  has  no  action  on  the  sound  skin;  it  is  but 
slightly  irritating  in  large  quantities  internally,  and  is 
not  poisonous. 

It  may  not  be  out  of  place  here  to  refer  to  a  popular 
error  regarding  a  point  of  diet:  that  is,  that  a  nursing 
woman  may  not  drink  lemonade  because  it  will  "  sour 
the  milk,"  and  "  give  the  baby  colic."  A  nurse  will 
probably  often  be  appealed  to  on  this  subject.  Her 
knowledge  of  the  chemical  facts — that  citric  acid  is 
decomposed  in  the  blood,  forming  a  neutral  salt;  that 
it  does  not  reach  the  tissues  as  an  acid,  but  passes  out 
of  the  body  as  a  carbonate — will  at  once  decide  the 
question. 


THE  ORGANIC  ACIDS.  1 1/ 

Acidum  Tartaricum,  Tartaric  Acid. 

Tartaric  acid  is  the  acid  of  the  grape,  and  is  made 
from  acid  tartrate  of  potassium  by  a  process  similar  to 
that  used  with  citric  acid. 

Its  local  action  upon  abraded  surfaces,  mucous  mem- 
branes, or  even  the  unbroken  skin,  is  that  of  a  decided 
irritant.  Taken  internally  it  is  diuretic  and  slightly 
laxative,  and  somewhat  depressing  to  the  heart. 

Tartaric  acid  does  not  enter  the  tissues  as  an  acid, 
but  is  decomposed  in  the  blood,  and  passes  out  of  the 
body  as  a  carbonate. 

Poisoning  and  Antidotes. 

In  large  doses  it  is  an  irritant  poison,  causing  burn- 
ing pain  of  the  oesophagus  and  stomach,  vomiting,  and 
gastro-intestinal  inflammation,  which  may  prove  fatal. 
A  dose  of  |  i.  has  caused  death  in  nine  days.  The 
alkalies,  magnesia,  lime,  soap-suds,  or  the  alkaline 
carbonates  are  antidotes. 

Average  dose,  gr.  viii.-o.5  Gm.,  freely  diluted. 

Acidum  Tannicum,  Tannic  Acid. 

There  are  two  kinds  of  tannic  acid,  of  which  the 
official  one  is  the  gallo-tannic,  and  is  obtained  by  treat- 
ing powdered  galls  with  washed  ether.  (Galls  are 
growths  of  plant  tissue  caused  by  parasitic  fungi  or 
insects,  whose  excretions  stimulate  the  plant  cells  to 
an  abnormal  development.  There  are  many  hundred 
varieties;  that  from  which  tannic  acid  is  made  being 
formed  on  an  oak  tree,  Quercus  lusitanica,  by  the  action 
of  the  fly  Cynips  gallce  tinctori<z.)  Tannic  acid  is  a 
light,  feathery,  yellow-white,  non-crystalline  powder, 
of  faint  odor  and  slightly  bitter  taste. 

Physiological  Actions. 

Locally  applied  it  is  an  active  astringent,  contract- 
ing the  tissues,  and  in  the  case  of  mucous  membranes 
causing  great  dryness.  It  coagulates  albumin  readily. 


Il8  MATERIA  MEDIC  A  FOR  NURSES. 

It  has  much  greater  strength  than  gallic  acid.  It  is 
used  to  overcome  relaxed  conditions,  and  to  check  ex- 
cessive secretions  of  the  skin  and  mucous  membranes. 
Parts  exposed  to  friction,  as  tender  feet  or  sore  nipples, 
may  be  successfully  hardened  by  the  use  of  tannic  acid. 
It  is  also  a  haemostatic. 

It  is  the  best  chemical  antidote  for  the  poisonous 
alkaloids,  but  its  administration  should  be  followed  by 
emetics  and  purgatives,  as  the  compounds  formed  are 
capable  of  being  dissolved  and  absorbed  in  the  alimen- 
tary canal. 

When  meant  to  act  on  the  stomach  it  is  usually 
given  in  powder;  on  the  bowels,  in  pill  form;  and 
locally,  as  an  ointment  or  lotion. 

Tannic  or  gallic  acid  in  some  form  is  contained  in 
and  gives  character  to  nearly  all  of  the  vegetable  astrin- 
gents, such  as  castanea  or  chestnut,  catechu,  geranium, 
pomegranate,  logwood,  harnamelis  or  witch  hazel, 
kino,  coto  bark,  alder,  diospyros  or  persimmon,  mango, 
Pinus  canadensis,  and  others. 

Preparations. 

Glyceritum  Acidi  Tannici. 
Glycerite  of  Tannic  Acid. 
Strength,  20  #. 

Unguentum  Acidi  Tannid    Not  official. 
Tannic  Acid  Ointment. 
Strength,  20  %. 

Trochisci  Acidi  Tannici. 
Troches  of  Tannic  Acid. 
I  gr.  each. 

Acidum  Gallicum,  Gallic  Acid. 

Gallic  acid  is  also  made  from  galls,  and  is  an  astrin- 
gent similar  to,  but  milder  than,  tannic  acid.  It  does 
not  coagulate  albumin. 

It  is  given  in  powder  and  pill,  the  average  dose 
being  gr.  xv.-i  Gm. 


THE  ORGA  NIC  A  CIDS.  1 1 9 

Acidum  Lacticum,  Lactic  Acid. 

Lactic  acid  is  found  in  sour  milk.  It  is  also  produced 
by  the  action  of  a  special  ferment  on  sugar,  and  is  one 
of  the  normal  constituents  of  the  gastric  juice.  It  is  a 
pale-yellow,  syrupy,  inodorous  liquid,  with  acid  taste. 

Lactic  acid  aids  digestion  and  promotes  appetite. 
It  is  credited  with  the  power  of  dissolving  fibrinous 
exudations,  but  its  use  as  an  application  is  very  pain- 
ful. Flatulence  and  epigastric  pain  result  from  its  too 
free  administration. 

It  enters  the  blood  as  alkaline  lactates,  is  decomposed, 
and  excreted  by  the  urine  as  carbonic  acid. 

Acidum  Lacticum  Dilutum.    Not  official. 
Dilute  Lactic  Acid. 

Consists  of  15  parts  acid  to  85  parts  water.    Dose 

3  ss.,  well  diluted. 

Acidum  Hydrocyanicum. 
Hydrocyanic  or  Prussic  Acid. 

The  pure  anhydrous  '  acid  is  a  colorless,  transparent, 
volatile,  and  inflammable  liquid,  so  poisonous  that  its 
fumes  alone  will  cause  death. 

Its  discoverer,  Scheele,  is  supposed  to  have  died  from 
inhaling  it.  It  is  not  official,  and  is  kept  only  in 
laboratories.  It  is  found  in  nature  in  a  number  of 
vegetable  substances,  viz.,  peach  kernels,  bitter  al- 
monds, wild  cherry,  cherry  laurel,  etc. 

Acidum  Hydrocyanicum  Dilutum. 
Diluted  Hydrocyanic  Acid. 

Made  by  distilling  aqueous  solutions  of  ferro-cyanide 
of  potassium  and  sulphuric  acid,  and  diluting  the  pro- 
duct with  the  water  to  the  required  strength.  A  color- 
less, watery  liquid,  containing  2  parts  of  the  pure  acid 

1  Without  water. 


120  MATERIA  MEDIC  A  FOR  NURSES. 

to  98  parts  alcohol  and  water.  Its  reaction  is  faintly 
acid;  the  taste  and  odor  like  those  of  peach  kernels  and 
bitter  almonds.  Under  the  influence  of  light  it  has  a 
tendency  to  decompose,  and  should  be  kept  in  dark- 
colored,  well-stoppered  bottles. 

Physiological  Actions. 

Applied  to  the  skin  the  acid  depresses  the  sensory 
nerves  and  causes  numbness.  It  is  therefore  used  for 
various  local  purposes,  largely  diluted,  but  should  never 
be  applied  to  an  abraded  surface  as,  being  readily 
absorbed,  poisoning  might  result. 

It  enters  the  blood  very  rapidly,  especially  through 
the  lungs,  enters  the  tissues  promptly,  and  acts  chiefly 
on  the  nervous  structures  as  a  sedative  and  depres- 
sant. The  respiratory  centre  is  especially  affected,  the 
respirations  weakened  and  slowed.  The  vaso-motor 
centre  is  stimulated  temporarily,  and  then  quickly  de- 
pressed. The  cardiac  centre  is  also  depressed,  though 
it  is  the  last  to  be  affected.  The  sedative  action  of  the 
drug  is  not  confined  altogether  to  the  nerve-centres,  but 
is  shown  also  on  the  muscular  structure  of  the  heart. 
The  motor  nerves  and  muscles  are  weakened  by  hydro- 
cyanic acid,  the  enfeebling  action  extending  downward. 

It  is  very  rapidly  eliminated  from  the  system,  prob- 
ably by  the  lungs.  This  is  not,  however,  a  settled 
point.  When  taken  in  medicinal  doses  hydrocyanic 
acid  causes  a  feeling  of  sleepiness.  The  first  peculiar 
effects  are:  a  bitter  taste,  an  increased  flow  of  saliva, 
and  a  feeling  of  irritation  and  constriction  of  the  throat. 
These  effects  pass  off  in  half  an  hour  or,  at  most,  an 
i  hour. 

When  the  dose  is  rather  larger  than  medicinal,  viz., 
about  ill  xxx.  of  the  weak  acid,  there  may  be  noticed: 
nausea,  transient  giddiness,  faintness,  a  feeble  pulse, 
and  general  muscular  weakness.  Sometimes  there  is 
vomiting,  or  foaming  and  frothing  at  the  mouth,  with 
a  suffused  or  bloated  appearance  of  the  face,  and  promi- 
nent eyes. 


THE  ORGA  NIC  A  CIDS.  1 2 1 

Symptoms  of  Poisoning. 

The  inhalation  of  the  vapor,  short  of  a  fatal  quantity, 
causes  giddiness,  faintness,  embarrassed  breathing,  a 
weak,  small  pulse,  and  even  coma  and  insensibility, 
followed  by  recovery. 

If  death  results  from  small  doses,  there  are  commonly 
present  tetanic  spasms,  lockjaw,  and  involuntary  evac- 
uations. 

Prussic  acid  is  one  of  the  most  powerful  poisons 
known,  and  after  a  toxic  dose  the  symptoms  come  on 
instantly,  and  death  may  result  in  a  few  moments. 
Among  its  most  marked  effects  are  the  insensibility 
and  loss  of  muscular  power,  which  are  produced  much 
more  rapidly  than  by  any  other  poison. 

There  is  usually  loss  of  consciousness  in  a  few 
seconds;  the  eyes  are  protruding  and  shining,  the 
pupils  dilated  and  irresponsive  to  light;  the  limbs  re- 
laxed and  covered  with  clammy  sweat;  the  pulse  im- 
perceptible; respiration  very  slow  and  convulsive, 
sometimes  stertorous,  sometimes  gasping,  or  sobbing, 
the  act  of  expiration  being  long  and  forced,  with  a 
pause  afterwards  during  which  the  patient  seems  dead. 

There  is  usually  an  odor  of  the  acid  on  the  breath. 
When  the  poisonous  dose  is  small,  yet  still  fatal,  there 
are  often  convulsions,  spasmodic  clinching  of  the 
fingers,  and  contraction  of  the  toes. 

The  smallest  fatal  dose  recorded  was  an  amount 
equivalent  to  gr.  -fa  of  pure  acid.  This  caused  death 
in  twenty  minutes.  Probably  the  average  fatal  dose  is 
about  gr.  i.  of  pure  acid,  and  the  average  time  of  death 
from  two  to  ten  minutes.  It  is  not  an  accumulative 
poison. 

Treatment  of  Poisoning. 

There  is  no  chemical  antidote  which  acts  quickly 
enough  to  be  of  any  service.  Cold-water  affusions  to 
the  head  and  spine,  and  artificial  respirations,  are  of 
more  service  than  anything  else,  and  should  be  per- 
severed in,  especially  the  latter,  as  long  as  there  is  any 


122  MATERIA  MEDIC  A  FOR  NURSES. 

sign  of  breathing;  as,  if  the  tendency  to  death  from 
apnoea  be  combated  until  the  influence  of  the  poison 
begins  to  pass  off,  life  may  be  saved.  The  stomach 
may  be  emptied  by  emetics  or  the  stomach-pump;  in- 
halations of  ammonia  and  chlorine  water  given;  and 
injections  hypodermically  of  ammonia,  ether,  and  alco- 
holic stimulants. 
Average  dose  of  dilute  acid,  TT[  iss.-o.  i  mil. 

Acidum  Oxalicum  (Oxalic  Acid). 

Oxalic  acid  is  never  used  in  medicine,  but,  as  a 
poison,  it  has  caused  accidental  death  so  often  that  it 
will  be  included  here.  There  are  two  forms  of  oxalic 
acid:  one,  the  simple  acid,  which  is  found  in  sorrel  and 
several  other  vegetable  substances;  the  other,  the 
article  known  as  essential  salt  of  lemon,  one  of  the 
most  violent  of  the  corrosive  poisons,  and  often  mis- 
taken for  Epsom  salt. 

Symptoms  of  Poisoning. 

A  hot,  acrid  taste,  and  burning  in  the  throat  and 
stomach;  intense  abdominal  pain,  and  vomiting  of 
greenish,  brown,  or  bloody  mucus  of  very  acid  reaction; 
livid,  cold  skin;  small,  irregular  pulse  ;  unconscious- 
ness, stupor,  and  collapse.  In  some  cases  the  gastric 
symptoms  predominate,  in  others  the  nervous  symp- 
toms, as  convulsions,  numbness,  paralysis,  and  stupor. 

The  smallest  fatal  dose  known  is  3  i.  An  ounce 
usually  proves  fatal,  and  the  symptoms  appear  imme- 
diately. Death  may  occur  within  a  few  minutes,  or 
may  be  delayed  more  than  a  week,  and  then  take  place 
from  starvation  resulting  from  the  injuries  to  the  in- 
testinal canal. 

Treatment  of  Poisoning. 

The  immediate  administration  of  an  antidote  is  of 
the  greatest  importance.  Neither  potash  nor  soda  can 
be  used,  as  their  oxalates  are  poisonous;  but  lime  and 


THE  CARBON  COMPOUNDS.  12$ 

chalk  are  perfect  antidotes,  and  can  be  given  as  pre- 
cipitated chalk  or  saccharated  solution  of  lime,  or  they 
may  be  scraped  off  the  wall,  whitewashed  fences,  or 
ceilings,  stirred  up  in  milk,  and  freely  administered. 
Emetics,  followed  by  the  soothing  and  demulcent 
drinks  usual  in  the  after-treatment  of  irritant  poi- 
sons, are  employed,  and  stimulants,  with  external 
warmth. 

Dr.  Potter  says  that  the  stomach  pump  should  never 
be  used  in  cases  of  oxalic  acid  poisoning. 

The  use  of  oxalic  acid  with  permanganate  of  potash 
in  the  surgical  theatre  as  a  part  of  the  process  of  hand 
and  finger-nail  disinfection  for  the  surgeon  is  dealt  with 
in  text-books  on  operating-room  technique. 


THE  CARBON  COMPOUNDS. 
Alcohol. 

Alcohol  is  a  product  which  results  from  a  process  of 
fermentation  in  substances  containing  grape-sugar — 
called  the  vinous  fermentation  in  distinction  from  the 
acetous  or  vinegar-forming  process. 

At  a  temperature  of  80°  F. ,  the  presence  and  growth 
of  the  fermenting  body  (a  low  vegetable  organism 
called  the  yeast-plant)  converts  a  solution  of  grape- 
sugar  into  alcohol  and  carbonic  acid.  Starchy  sub- 
stances yield  alcohol,  starch  being  convertible  into 
grape-sugar.  From  these  vinous  or  fermented  liquors 
alcohol  is  obtained  by  repeated  distillation.  It  is  also 
made  synthetically,1  by  shaking  olefiant  gas  (a  gas 
composed  of  carbon  and  hydrogen,  which  is  generally 
present  in  coal  gas,  oil  gas,  and  other  gaseous  mixtures 
produced  by  the  action  of  heat  on  organic  substances) 
with  strong  sulphuric  acid,  diluting  and  distilling. 
Alcohol  is  a  colorless,  volatile  liquid,  of  strong  pungent 
odor  and  burning  taste;  it  is  inflammable,  burning 

1  By  uniting  elements  into  a  compound. 


124  M./LTERIA  MEDICA  FOR  NURSES. 

without  smoke  and  with  a  blue  flame,  evaporates  on 
exposure  to  the  air,  is  vaporized  by  heat,  and  unites 
readily  with  water  in  all  proportions* 

There  are  three  important  alcohols  or  varieties  of 
alcohol,  viz. :  (The  two  last  are  not  official.) 

1.  Alcohol   Ethylicum,  Ethyl  Hydrate,  Grain 
Spirit.     This  is  the  alcohol  of  common  language. 

2.  Alcohol  Amylicum,  Amyl  Hydrate,  Potato 
Spirit,  called  fusel  oil,  and  obtained  also  as  an  impurity 
in  the  production  of  ethylic  alcohol  by  continuing  the 
distillation  after  the  pure  spirit  has  ceased  to  come 
away.     Ainylic  alcohol  is  not  inflammable. 

3.  Alcohol  Methylicum,  Methyl  Hydrate,  Wood 
Spirit.    Wood  spirit  is  inflammable,  and  is  cheaper 
than  alcohol. 

Methyl  alcohol  is  slowly  fatal  if  administered  in 
small  doses  for  a  long  time,  or  rapidly  fatal  if  taken  in 
large  doses  at  one  time,  and  causes  optic-nerve  atrophy 
— "  methyl  alcohol  blindness."  Its  commercial  use  in 
many  essences,  Jamaica  ginger,  soda  water,  ales,  etc., 
and  in  the  form  of  "  Columbian  spirit,"  witch  hazel, 
bay  rum,  eau  de  cologne,  peruna,  etc.,  is  exceedingly 
dangerous. 

Liquor  Formaldehydi. 
Solution  of  Formaldehyde. 

Formaldehyde  is  derived  from  the  oxidation  of  wood 
alcohol.  It  is  antiseptic,  disinfectant,  deodorant,  and 
germicidal  in  its  action.  It  may  be  used  either  in 
solution  in  water  (formaline)  or  as  a  vapor.  Its  action 
seems  to  be  specific  for  the  destruction  of  lower  animal 
and  plant  life,  but  not  for  the  higher  animals.  Sul- 
phur is  a  better  germicide  for  insects  than  formaldehyde, 
and  the  action  of  the  latter  is  simply  irritant  to  human 
beings.  Formaldehyde  is  as  efficient  as  corrosive  sub- 
limate and  penetrates  more  rapidly.  It  is  too  irritating 
as  an  antiseptic  in  general  surgery,  but  may  be  used  in 
solutions  of  i :  500  or  1000.  Instruments  can  be  sterilized 


THE  CARBON  COMPOUNDS.  125 

in  a  solution  of  1:200  formaline.  It  may  be  employed 
as  a  deodorant,  and  as  a  disinfectant  for  stools  and 
sputa  in  5  %  solution.  A  solution  of  i :  50  may  be  used 
for  sweating  feet  Clothing  may  be  thoroughly  disin- 
fected by  placing  the  articles  in  a  compartment,  causing 
a  vacuum,  and  distilling  the  gas  into  this  compartment 
where  it  penetrates  thoroughly  into  every  article.  In 
the  disinfection  of  rooms  the  gas  should  be  admitted 
under  pressure  through  the  keyhole,  after  the  room 
has  been  made  practically  air-tight.  The  gas  from 
150  c.c.  of  40  %  formaline  is  sufficient  for  each  1000 
cubic  feet  of  space.  The  room  should  be  closed  for 
twenty-four  hours  and  before  entering  it  a  small  amount 
of  ammonia  may  be  sprayed  into  the  room  to  precipi- 
tate the  formaldehyde,  thus  preventing  the  extremely 
irritant  effects  on  the  eyes  and  mucous  membranes, 
when  the  room  is  entered. 

Poisoning  is  very  rarely  reported.  Large  amounts 
internally  or  as  douches  cause  toxaemia  by  shrivelling 
up  the  red  blood  cells,  with  the  formation  of  haematin. 
There  may  be  vomiting,  purging,  dyspnoea,  cyanosis, 
and  collapse.  Ammonia  water  is  the  antidote. 

Physiological  Actions. 

The  action  of  alcohol  is  both  local  and  general.  It 
is  an  irritant  in  either  case;  an  irritant  being  a  drug 
that  disorders  or  disorganizes  function,  in  contradis- 
tinction to  a  stimulant,  which  increases  activity, 
thereby  increasing  function.  Its  local  action  is  the 
more  important,  for  its  entire  effect  may  be  due  to  the 
local  irritant  action  on  the  skin  and  mucous  membrane, 
and  after  absorption  on  the  endothelium  of  the  blood- 
vessels  or  their  intrinsic  nervous  apparatus,  on  the 
heart  and  skeletal  muscles,  on  the  brain  and  nervous 
system,  on  the  organs,  and  on  all  the  cellular  elements 
of  the  body.  It  produces  at  first  a  disorderly  reaction 
by  its  irritant  effect,  finally  causing  fatigue,  or  com- 
plete inactivity  of  all  parts  by  depression,  depending 
upon  the  amount  taken  and  the  condition  of  the  indi- 


126  MATERIA  MEDIC  A  FOR  NURSES. 

vidual,  etc.  As  in  the  case  of  any  other  poison  there  is 
a  certain  reaction  in  the  organs  and  their  functions  in 
attempting  to  get  rid  of  the  noxious  element.  Alco- 
hol has  great  affinity  for  nervous  tissue.  The  brain 
responds  by  losing  its  power  of  inhibition,  thus  allow- 
ing free  play  to  the  emotions,  while  lessening  will 
power.  At  first  there  is  a  quicker  response  to  stimuli, 
but  finally  less  capacity  for  accurate  work  either 
mental  or  physical.  The  respirations  are  increased  in 
frequency,  the  alcohol  being  oxidized  rapidly,  and 
eliminated.  The  heart  becomes  more  active  and  force- 
ful as  a  result  of  the  dilatation  of  the  peripheral  blood- 
vessels, due  to  paralysis  of  the  vaso-constrictors,  de- 
creasing the  resistance  to  the  action  of  the  heart,  and 
by  paralysis  of  the  cardiac  inhibitory  nerves,  thus  giv- 
ing the  cardiac  acceleration  full  play.  Small  quantities 
of  alcohol  after  meals  may  improve  the  digestion  by 
irritating  the  mucous  membrane  to  greater  activity, 
but  prolonged  regular  use,  or  large  quantities  taken  at 
one  time,  especially  on  an  empty  stomach,  create  grave 
indigestion  by  causing  a  catarrhai  condition  of  the 
mucous  membranes.  Muscular  activity  is  increased, 
for  a  few  minutes,  but  in  a  disorderly  way,  and  is 
rapidly  followed  by  fatigue.  Experiments  prove  that 
alcohol  in  even  minute  quantities  is  detrimental  to  rifle- 
men at  target  practice,  tight-rope  performers  in  their 
acts,  and  whenever  fine  adjustments  of  nerve  and 
muscle  are  necessary.  likewise  it  has  been  found  to 
be  harmful  to  mountain  climbers,  who  are  unable  to 
carry  on  their  feats  of  skill  and  endurance,  to  soldiers 
on  the  march,  and  to  labor  in  all  conditions.  Theo- 
retically alcohol  is  a  food,  saving  tissue  waste  by 
taking  the  place  of  fats  and  carbohydrates  in  the  pro- 
duction of  heat  and  energy,  but  practically  it  is  of  no 
value.  It  is  not  a  serviceable  food,  but  an  oxidizable 
drug,  and  may  require  more  energy  to  overcome  its 
irritant  effects  than  it  creates  by  stimulating,  if  it  does 
really  stimulate.  Alcohol  acts  peculiarly  by  lowering 
body  temperature  and  vitality,  thus  inviting  inroads 
by  any  or  all  diseases  that  may  be  prevalent,  or  with 


THE  CARBON  COMPOUNDS.  127 

which  the  person  may  come  into  contact.  Its  poison- 
ous properties  are  thus  manifested,  and  European 
studies  have  proved  beyond  a  doubt  that  it  is  detri- 
mental. It  is  absolutely  bad  for  children  and  nervous 
persons. 

In  morbid  states  alcohol  may  be  of  service,  as  to  tide 
over  a  crisis  in  fever,  but  it  should  never  be  used  in 
case  of  shock,  or  during  anaesthesia,  because  better 
remedies  may  be  applied. 

Alcohol  is  locally  antiseptic  and  disinfectant, 
cooling,  and  astringent.  Internally,  in  medicinal 
doses  it  is  pre-eminently  a  heart  stimulant,  and,  in 
a  lesser  degree,  a  diuretic,  diaphoretic,  and  anti- 
pyretic. 

When  rubbed  into  the  skin,  as  for  the  prevention  of 
bed-sores,  it  disinfects  and  hardens  it,  checks  the 
activity  of  the  sweat  glands,  and  irritates  the  cutaneous 
nerves,  causing  redness,  heat,  and  local  anaesthesia. 
Applied  and  allowed  to  evaporate,  as  in  sponge  baths, 
it  has  a  cooling  action.  Coming  in  contact  with  an 
abraded  surface  it  is  very  painful.  It  is  absorbed  by 
the  unbroken  skin.  In  the  stomach  it  produces  a  sense 
of  warmth,  and,  in  moderate  amount,  stimulates  the 
mucous  membrane  and  dilates  the  small  vessels,  with 
the  result  that  the  blood  supply  is  increased  and  the 
gastric  secretion  is  correspondingly  abundant. 

When  used  in  doses  sufficient  to  give  this  result 
simply,  alcohol  is  evidently  favorable  to  digestion,  but 
in  larger  quantities  it  has  another  and  unfavorable 
action,  namely,  that  of  precipitating  the  pepsin  of  the 
stomach. 

Overdoses  produce  this  result;  a  small  quantity, 
diluted  as  it  is  by  the  gastric  fluids,  has  not  sufficient 
power  to  act  on  the  pepsin  to  any  marked  degree.  If 
alcohol  is  constantly  used  to  excess,  an  abnormal 
secretion  of  mucus  —  gastric  catarrh  —  results,  with 
various  evidences  of  dyspepsia,  viz. :  loss  of  appetite, 
acidity  of  stomach,  heartburn  and  pyrosis,  nausea,  and 
morning  vomiting. 

Other  evidences  of  the  alcohol  habit  are:  constipa- 


128  MATERIA  MEDICA  FOR  NURSES. 

tion;  pain  on  pressure  over  the  stomach;  brown,  dry 
tongue  with  red  tip;  chronic  pharyngitis;  fat,  flabby, 
soft  hands. 

Sleep,  for  the  first  part  of  the  night,  is  sound,  but  is 
disturbed  in  the  early  morning,  after  which  wakefulnesa 
remains,  or  broken  sleep  with  bad  dreams. 

Confirmed  drinkers  age  fast.  The  skin  becomes  dry, 
and  feels  waxy,  soft,  and  unhealthy.  The  mind  be- 
comes sluggish  and  weak,  and  cirrhosis  of  the  liver  and 
kidneys,  phthisis,  epilepsy,  paraplegia,  insanity,  and 
other  disorders  are  among  the  sequels  of  alcoholism. 

Alcohol  enters  the  blood  unchanged  or  as  aldehyde,1 
and  reaches  the  tissues  and  organs,  a  small  portion 
being  changed  into  acetic  and  carbonic  acids.  In  its 
passage  through  the  tissues  it  is  oxidized,  if  given  in 
moderate  amount,  and  changed  into  carbonic  acid  and 
water,  like  other  carbo-hydrates, —  thus  becoming  a 
food  or  source  of  heat  and  force. 

In  a  healthy  adult,  §  iss.  of  absolute  alcohol  can  be 
thus  oxydized  in  twenty-four  hours,  and  supplies  to  the 
organism  as  much  heat  and  energy  as  is  contained  in 
the  same  amount  of  cod-liver  oil  or  in  about  §  ix.  of 
beef. 

Beyond  this,  in  health,  it  becomes  injurious,  and  is 
eliminated  by  the  kidneys,  skin,  and  lungs;  though  in 
different  morbid  states  large — even  excessive — quanti- 
ties can  be  safely  taken. 

Although  alcohol  is  itself  oxydized,  it  interferes  with 
the  oxidation  of  other  substances,  thus  saving  the  tis- 
sues from  wear  and  retarding  the  process  of  waste. 

This,  joined  to  its  apparent  stimulating  action  on 
the  circulation  and  on  the  nervous  system,  gives  it  the 
power  of  sustaining  life  for  a  time,  under  the  strain  of 
acute  exhausting  disease,  or  during  a  period  of  tem- 
porary inability  to  take  sufficient  food. 

Its  apparently  stimulant  effect  is  shown  on  the  heart 
by  an  increase  in  the  strength  of  the  contraction  or 
systole.  The  pulse  becomes  strong  and  regular,  full, 

1  Alcohol  deprived  of  a  certain  proportion  of  its  hydrogen. 


THE  CARBON  COMPOUNDS.  129 

and  compressible.  If  it  had,  before,  been  rapid  and 
weak,  it  will,  under  the  favorable  influence  of  alcohol, 
become  reduced  in  frequency  to  near  the  normal;  but, 
if  over-stimulated,  this  shortening  of  the  period  of  rest 
will  in  time  exhaust  the  heart. 

In  giving  alcohol  as  a  medicine,  it  is  important  to  be 
able  to  recognize  the  first  evidences  of  over-stimulation 
as  given  by  the  pulse. 

The  '  *  whisky  pulse, "  as  it  is  called,  is  unnaturally 
strong,  full,  frequent,  and  bounding. 

On  the  brain  and  nervous  system  alcohol  acts  as  a 
stimulant,  up  to  a  certain  point;  beyond  that,  as  a 
depressant  and  narcotic. 

On  the  circulation  and  bodily  heat  its  action  would, 
at  first  sight,  seem  to  be  contradictory.  The  sense  of 
warmth  given  by  a  dose  of  alcohol  seems  incompatible 
with  the  well-proved  facts  that  the  bodily  heat  is,  on 
the  whole,  lowered  by  alcohol,  and  that  the  power  of 
resistance  to  cold  is  weakened  by  its  use. 

The  physiological  explanation  is,  that  the  blood-ves- 
sels are  dilated  by  paralysis  of  the  vaso-constrictors, — 
the  blood  rushes  to  the  surface  to  fill  the  superficial  ves- 
sels, and  a  feeling  of  warmth  results,  which,  in  a  warm 
or  moderately  cool  atmosphere,  remains,  and  promotes 
the  general  comfort;  but,  in  a  cold  atmosphere,  the 
supply  of  blood  to  the  surface  being  so  much  larger 
than  ordinary  and  perspiration  being  also  increased, 
while  active  tissue-changes  are  checked,  heat  is  ab- 
stracted from  the  body  by  evaporation  at  a  rate  which, 
soon  affects  the  vital  powers  seriously. 

In  giving  stimulants  there  are  various  points  to 
notice  by  which  to  judge  whether  it  is  doing  good  or 
not. 

The  pulse  has  been  mentioned;  the  tongue  gives 
another  indication.  If  a  dry  tongue  becomes  moist 
under  the  influence  of  alcohol,  it  is  acting  well;  if  the 
dryness  of  the  tongue  be  increased,  it  is  not,  and 
the  same  rule  applies  to  the  skin.  If  nervousness  is 
quieted,  sleep  induced,  delirium  and  subsultus  lessened 
by  alcohol,  it  is  acting  favorably;  if  restlessness  and 


130  MATERIA  MEDIC  A  FOR  NURSES. 

uneasiness  follow,  or  increased  delirium,  or  sleepless- 
ness, — unfavorably. 

In  cases  of  sudden  heart  failure  alcoholic  stimulants 
are  given  hot  and  concentrated. 

Dilute  alcohol  administered  early  is  a  valuable  anti- 
dote in  carbolic  acid  poisoning. 

Symptoms  of  Poisoning. 

A  steady  course  of  alcohol  in  excess,  without  taking 
food,  will  result  in  delirium  tremens.  Acute  alcoholic 
poisoning  presents  the  following  symptoms:  a  short 
period  of  excitement,  followed  by  coma;  respirations 
irregular,  sometimes  sighing  but  usually  stertorous; 
pupils  either  dilated  or  contracted,  usually  the  former; 
face  flushed;  pulse  hard,  rapid,  and  strong. 

Acute  alcoholic  poisoning  may  be  mistaken  for  opium 
poisoning,  apoplexy,  or  compression  of  the  brain. 

Death  results  from  paralysis  of  the  heart  and  respira- 
tions. The  time  at  which  death  may  occur  varies  from 
a  few  minutes  to  several  days. 

The  smallest  known  fatal  dose  was  between  §  iii.-iv. 
of  brandy  swallowed  by  a  child  of  seven.  One  pint  or 
200  Cc.  of  whisky  at  one  time  is  a  fatal  dose. 

Treatment  of  Poisoning. 

The  treatment  consists  in  emptying  the  stomach;  the 
application  of  heat  to  the  extremities  and  cold  affusions 
to  the  head;  the  inhalation  of  ammonia,  and  the  use 
of  electricity  applied  to  the  respiratory  muscles. 

Preparations  of  Alcohol. 

Alcohol. 
Alcohol. 

Contains  94.9  £  by  volume,  92. 3  #  by  weight,  of 
pure  ethyl  alcohol  with  7.7  of  water. 


THE  CARBON  COMPOUNDS.  131 

Alcohol  Dehydratum. 

Dehydrated  Alcohol. 

Alcohol  Absolutum.    U.  S.  P.,  viii. 

Made  from  alcohol  by  a  lengthy  chemical  process. 
It  consists  of  not  less  than  99%  by  weight  of  alcohol, 
and  is  not  kept  for  sale  but  used  only  for  pharmaceutical 
purposes. 

Spiritus  Tenuior. 
Proof  Spirit.  Not  official. 

Equal  parts  of  alcohol  and  water,  or,  strictly  speak- 
ing,  49  per  cent,  alcohol. 

Alcohol  Dilutum. 
Diluted  Alcohol. 

41  %  by  weight,  of  alcohol,  48.6  #  by  volume. 
Alcoholic  Beverages. 

Spiritus  Frumenti.    (U.  S.  P.,  viii.  Dismissed  from  U.  S.  P.,  ix.) 
Whisky. 

Made  in  the  United  States  from  rye  and  corn,  in 
Scotland  from  barle}',  and  in  Ireland  from  potatoes. 

It  has  from  44  to  50  per  cent,  by  weight  of  ethyl  alco- 
hol (by  volume  50  to  56  per  cent.),  and  contains  ethers 
which  are  developed  in  the  course  of  its  fermentation; 
and,  even  in  the  best  varieties,  some  traces  of  fusel  oil. 
Whisky  should  be  at  least  two  years  old  before  it  is 
used. 

The  use  of  alcoholic  beverages  as  medicinal  agents 
is  being  rapidly  discontinued,  and  if  whisky  is  ordered 
in  medical  treatment  the  dosage  is  small  tand  con- 
centrated. 

Spiritus  Vini  Gallici.  (U.  S.  P.,  viii.  Dismissed  from  U.S. P.,  ix.) 
Brandy. 

Brandy  should  be  distilled  from  grapes,  but  it  is  also 
made  artificially.  It  has  about  the  same  percentage  of 
alcohol  as  whisky.  It  may  be  either  pale  or  dark;  in 


132  MATERIA  MEDICA  FOR  NURSES. 

the  former  case  it  is  colored  by  the  cask,  in  the  latter  it 
contains  caramel.  It  should  be  at  least  four  years  old. 
Brandy  has  a  more  sedative  action  on  the  stomach  than 
whisky,  and  is  preferable  where  there  is  any  tendency 
to  diarrhoea,  as  it  is  slightly  constipating,  containing 
a  little  tannin.  Both  brandy  and  whisky  are  more 
easily  taken,  as  medicines,  if  poured  over  a  small  glass- 
ful of  cracked  ice;  or  they  may  be  diluted  with  carbon- 
ated or  seltzer  water  more  acceptably  than  with  plain 
water.  Giving  them  in  milk  very  often  causes  patients 
to  take  a  dislike  to  the  milk.  They  are  both  used 
hypodermically,  and  for  this  purpose  should  always  be 
filtered. 

Rum.    Not  official. 

Made  by  the  distillation  of  fermented  molasses. 
Gin.    Not  official. 

Distilled  from  rye  or  barley,  and  flavored  with  juni- 
per berries.  If  it  is  pure  it  is  an  efficient  diuretic, 
owing  to  the  oil  of  juniper,  but  it  is  rarely  pure. 

Wines.    Not  official. 

Wines,  brandy,  and  whisky  have  been  excluded 
from  U.  S.  P.,  ix.,  because  of  their  inexact  contents  cf 
alcohol.  White  wine  contains  about  10  per  cent,  of 
alcohol,  and  is  made  from  grape  juice  without  skins, 
stems,  or  seeds. 

All  wines  contain  various  acids  and  traces  of  mineral 
substances.  Those  which  are  free  from  sugar  are  called 
"dry"  wines. 

The  red  wines — claret,  port,  etc. — are  made  from 
colored  grapes  with  the  skins,  and  have  considerable 
alcoholic  strength.  Port  wine,  vinum  portense,  con- 
tains from  30  to  40  per  cent,  of  alcohol,  but  is  rarely 
pure. 

As  stimulants  and  in  narcotic  power  these  wines 
stand  next  to  brandy  and  whisky.  They  contain  some 
tannic  acid  and  are  astringent,  causing  constipation 


THE  CARBON  COMPOUNDS.  133 

and  disordering  the  stomach.  They  also  tend  to  raise 
the  temperature. 

Vinum  xericum,  or  sherry,  belongs  to  the  dry  spirit- 
uous wines.  It  contains  17  per  cent,  of  alcohol,  and  is 
usually  made  artificially.  It  assists  digestion  if  taken 
during  meals. 

Sparkling  wines,  of  which  champagne  is  the  most 
important,  are  bottled  before  fermentation  is  complete, 
and  are  effervescent,  being  charged  with  carbonic  acid. 
They  are  more  intoxicating  than  others  in  proportion 
to  their  strength,  are  less  stimulating  to  the  heart, 
and  liable  to  leave  headache  and  sour  stomach  as  after- 
effects when  freely  taken.  In  small  doses  they  are 
gastric  sedatives,  champagne  especially  being  so. 
Given  ice-cold  and  in  teaspoonful  doses,  at  short  inter- 
vals, it  may  be  retained  by  an  irritable  stomach  which 
rejects  everything  else.  In  giving  champagne  in  this 
way  care  is  necessary  to  prevent  escape  of  the  gas  and 
flattening  of  the  wine.  A  champagne  tap  is  used,  and 
the  bottle  held  head  downward.  In  the  intervals  it  is 
kept  on  ice  in  the  same  position. 

Sweet  wines,  including  Burgundy  and  Madeira,  are 
rather  trying  to  the  digestion.  They  disorder  the 
stomach  and  cause  headache.  They  contain  6  or  7  per 
cent,  of  alcohol. 

Dry  acid  wines — the  German  and  some  of  the  French 
wines — are  stimulant,  and  do  not  cause  acid  fermenta- 
tion. They  contain  from  5  to  7  per  cent,  of  alcohol. 

Beer,  Ale.  Porter,  Stout, 

Contain  from  2  to  6  per  cent,  of  alcohol;  also  extract 
of  malt,  lactic  acid,  salts  of  potash  and  of  soda,  and 
aromatics. 

Chloroformum,  Chloroform. 

Chloroform  is  made  by  the  action  of  chlorine  on 
alcohol. 

Physiological  Actions. 

Externally  applied  and  allowed  to  evaporate,  chlo- 
roform causes  a  sense  of  coldness  and  depresses  the 


134  MATERIA  MEDIC  A   FOR  NURSES. 

terminations  of  the  sensory  nerves,  acting  as  an  anodyne 
and  producing  insensibility  to  pain.  If  evaporation  is 
prevented  it  irritates,  reddens,  and  blisters  the  skin. 
These  effects  are  followed  by  anaesthesia  of  the  part. 
Given  by  mouth,  chloroform  has  a  hot,  sweet  taste, 
and  in  the  stomach  produces  a  feeling  of  warmth.  In 
large  quantities  or  undiluted  it  causes  violent  gastro- 
enteritis. Medicinally  it  is  given  as  an  an tispasmodic, 
anodyne,  and  carminative.  It  enters  the  circulation 
through  the  lungs,  stomach,  and  unbroken  skin.  It 
reaches  the  tissues  very  rapidly,  and  exerts  its  greatest 
power  on  the  central  nervous  system.  It  is  excreted 
partly  as  chloroform  by  the  kidneys,  lungs,  mammary 
glands,  and  skin,  and  part  is  lost  in  the  system. 


Symptoms  of  Poisoning. 

In  poisoning  by  chloroform  taken  internally  the 
symptoms  are:  stupor;  cold  skin  covered  with  perspi- 
ration ;  pulse  slow,  thread)',  sometimes  almost  imper- 
ceptible ;  respirations  at  first  stertorous,  afterwards 
becoming  shallow,  irregular,  and  infrequent.  The 
symptoms  come  on  almost  immediately  after  it  has 
been  swallowed,  and  death  may  result  in  a  few  hours, 
or  may  result  after  a  longer  time  from  gastro-enteritis 
or  from  inflammation  of  the  trachea. 


Treatment  of  Poisoning. 

There  is  no  antidote  for  chloroform,  on  account  of  its 
extremely  rapid  difFusibility  through  the  system.  The 
stomach  must  be  emptied,  washed  out,  if  necessary, 
and  cold-water  affusions  applied  to  the  head,  and  plenty 
of  fresh  air  admitted.  Artificial  respiration  should  be 
practised  steadily  and  unremittingly. 

The  smallest  fatal  dose  recorded  is  3  ii. 

Average  dose  of  chloroform,  ill  v--o.3  mil. 


THE  CARBON  COMPOUNDS.  135 

Spirit  us  Chloroform!. 
Spirit  of  Chloroform. 

Strength  6%. 

Average  dose,  TH,  xxx.-2  mils. 

Aqua  Chloroform!. 
Chloroform  Water. 

Average  dose,  §  ss.-i5  mils. 
Chlorodyne.     Not  official. 

A  proprietary  medicine  containing  chloroform,  ether, 
morphine,  cannabis  indica,  and  hydrocyanic  acid. 
Average  dose,  TH,  xv.-i  mil,  well  diluted. 

Linimentum  Chloroform!. 
Chloroform  Liniment. 

Composed  of  soap  liniment  and  chloroform. 

Linimentum  Chloroform!  Compositum. 
Compound  Chloroform  Liniment.   Not  official. 

Contains  chloroform,  oil  of  turpentine,  laudanum, 
tincture  of  aconite,  and  soap  liniment. 

Chloroform  Anaesthesia. 

In  the  use  of  the  vapor  of  chloroform  as  an  anaesthetic 
there  are  three  stages  of  narcosis:  the  first,  a  short 
period  of  excitement  during  which  the  sensibilities  are 
blunted,  though  consciousness  is  not  lost;  second,  the 
stage  of  anaesthesia.  Consciousness  and  sensibility  are 
abolished;  the  pulse  is  about  normal  in  frequency  and 
slightly  weaker;  respiration  slow,  heavy,  and  stertor- 
ous. During  this  period  operations  are  performed. 
The  third  stage  is  a  dangerous  one,  with  profound 
narcosis;  en  tire  muscular  relaxation;  stertorous  breath- 
ing, gradually  becoming  sighing  and  weak;  and  com- 
plete abolition  of  reflex  actions. 


MATERIA  MEDIC  A  FOR  NURSES. 

Chloroform  is  preferred  to  ether  in  some  cases  because 
it  is  easier  and  pleasanter  to  take;  is  more  prompt  in 
its  action;  is  not  so  nauseating,  and  its  after-effects 
pass  away  more  quickly.  In  obstetrical  cases  it  is 
preferred  because  by  its  use  a  stage  of  insensibility  to 
pain  can  be  produced  without  bringing  on  complete 
muscular  relaxation,  which  would  delay  labor. 

No  fatal  cases  are  known  to  have  occurred  in  par- 
turient women,  although  in  surgical  cases  death  has 
occurred  quite  frequently  and  with  great  suddenness, 
from  paralysis  of  the  respirations  and  heart,  and  ordi- 
narily chloroform  is  considered  much  less  safe  than 
ether.  In  giving  chloroform  to  a  patient  in  labor 
(which  a  nurse  may  be  required  to  do),  the  face  must 
first  be  oiled  with  vaseline  to  prevent  any  possibility  of 
blistering. 

About  3  ss.  of  chloroform  is  poured  at  one  time  on  a 
sponge,  or  piece  of  lint,  and  held  before  the  nose  in 
a  way  that  will  allow  plenty  of  air  to  mix  with  it,  as 
the  chloroform  should  only  be  in  a  strength  of  3  per 
cent,  with  the  inspired  air  when  inhaled. 

It  is  only  to  be  inhaled  during  the  existence  of  a 
pain,  and  not  in  sufficient  quantity  to  lessen  uterine 
contraction.  If  the  pulse  weakens,  the  respirations 
grow  shallow,  or  the  pains  become  insufficient,  it  is 
stopped. 

It  is  well  to  keep  the  supply  safely  put  of  reach  in 
the  case  of  excitable  and  hysterical  patients. 

In  the  treatment  of  poisoning  by  inhalation  of  chlo- 
roform vapor,  the  head  is  lowered  to  an  angle  of  about 
40°.  Plenty  of  fresh  air  is  needed,  and  should  be 
warm,  about  8o°-85°  F.  External  heat  must  be  ap- 
plied, and  artificial  respiration  kept  up  for  several 
hours. 


Ether. 

A  colorless,  volatile  liquid,  made  by  the  action  of 
sulphuric  acid  on  alcohol,  by  a  very  elaborate  process. 


THE  CARBON  COMPOUNDS.  137 

It  evaporates  rapidly  on  exposure  to  the  air,  and  is 
very  inflammable,  as  is  also  the  vapor.  The  odor  is 
very  strong,  heavy,  and  peculiar. 

Physiological  Actions. 

Applied  to  the  skin  and  allowed  to  evaporate,  ether 
is  a  refrigerant  and  local  anaesthetic  of  such  power 
that  minor  surgical  operations  are  sometimes  performed 
under  its  local  influence;  the  part  to  be  operated  on — 
as,  for  instance,  a  finger — being  sprayed  with  ether 
until  benumbed,  a  process  which  requires  only  a  few 
moments'  time. 

Internally  it  has  a  strong  burning  taste,  is  irritant 
to  mucous  membrane,  and  causes  salivation  through 
reflex  action.  In  the  stomach  it  acts  as  a  local  stimu- 
lant and  carminative,  and  also,  by  reflex  action,  as  a 
stimulant  to  the  heart,  respiratory  organs,  brain,  and 
intestines. 

It  is  an  antispasmodic,  anthelmintic,  and  diapho- 
retic. When  inhaled  it  first  produces  a  strong  irrita- 
tion of  the  throat,  with  a  strangled  feeling.  The 
cerebrum  is  first  affected  by  the  use  of  ether  as  an 
anaesthetic;  the  sensory  and  motor  nerves  next;  the 
centres  of  respiration  and  circulation  in  the  medulla  are 
the  last  to  become  influenced,  and  continue  to  act, 
unless  the  anaesthetic  is  pushed  too  far,  when  the  res- 
pirations die  away,  the  heart  continuing  to  beat  aftei 
breathing  has  stopped.  Reflexes  from  nose  (fifth  nerve) 
-and  rectum  are  the  last  to  be  abolished. 

The  state  of  the  bladder  must  be  carefully  watched 
in  all  cases  after  etherization,  as  there  is  often  retention 
of  urine.  External  heat  must  be  plentifully  supplied, 
and  the  facility  with  which  an  insensible  patient  may 
be  seriously  burned  by  hot-water  bottles  and  bags 
should  be  constantly  kept  in  mind.  The  effects  of  the 
ether  are  allowed  to  pass  off  quietly  of  themselves, 
plenty  of  fresh  air  being  secured,  any  effort  at  vomiting 
being  best  overcome  by  giving  a  teaspoonful  of  very 
hot  water  at  intervals.  If  there  is  no  tendency  towards 
collapse,  cracked  ice  in  small  quantities  may  be  used. 


138  MATERIA  MED  1C  A  FOR  NURSES. 

In  preparing  a  patient  for  etherization,  definite  orders 
from  the  surgeon  are  always  received,  and  it  is  only 
necessary  here  to  speak  of  the  absolute  importance  of 
having  the  stomach,  bowels,  and  bladder  entirely 
empty. 

Death  from  strangulation  may  be  caused  by  a  frag- 
ment of  vomited  food  lodging  in  the  windpipe,  and  the 
bowels  and  bladder,  if  not  thoroughly  attended  to,  will 
empty  themselves  spontaneously. 

Kther  is  excreted  like  chloroform,  and  rapidly.  The 
anaesthetic  mixture  of  Nussbaum  is  formed  of  ether  3 
parts,  alcohol  and  chloroform  each  i  part. 

Preparations  of  Ether. 

Spiritus  Athens 

Spirit  of  Ether.    Hoffman's  Drops. 

Has  32.5  parts  of  ether  and  67.5  of  alcohol. 
Dose,  3  i.~4  mils,  well  diluted  with  cold  water. 

Spiritus  Athens  Compositus. 
Compound  Spirit  of  Ether. 
(Hoffman's  Anodyne.) 

Contains  32.5%  ether,  with  alcohol  and  ethereal  oil. 

It  is  a  carminative,  antispasmodic,  and  stimulant. 

Dose,  3  i.-4  mils,  diluted  with  very  cold  or  iced  water. 

Spiritus  ^Etheris  Nitrosi. 
Spirit  of  Nitrous  Ether. 
Sweet  Spirit  of  Nitre. 

A  solution  of  sodium  nitrite  in  alcohol,  with  the 
addition  of  sulphuric  acid,  monhydrated  sodium  car- 
bonate and  potassium  carbonate.  Sweet  spirit  of  nitre 
is  volatile  and  inflammable.  It  should  not  be  kept 
long,  as  it  becomes  acid  with  age.  It  is  a  diuretic  and 
diaphoretic,  acting  by  relaxing  and  dilating  the  renal 


THE  CARBON  COMPOUNDS.  139 

and  cutaneous  vessels.  It  is  also  a  nerve  sedative 
and  antispasmodic. 

The  action  on  the  skin  is  made  more  prominent  by 
keeping  the  patient  warmly  covered  in  bed,  and  on 
the  kidneys  when  kept  cool,  or  out  of  bed.  Like  all 
preparations  of  ether  it  should  be  largely  diluted  and 
given  very  cold,  as  this  lessens  the  strangling  feeling  in 
the  throat. 

The  inhalation  of  sweet  spirit  of  nitre  has  caused 
alarming  symptoms — viz. :  pallor,  weak  pulse,  muscular 
weakness,  pain  about  the  heart,  and  headache. 

Taken  internally,  in  large  quantities,  it  has  in  one 
or  two  instances  caused  death. 

Average  dose,  TIJ,  xxx.-2  mils. 

Preparations  of  ether  are  given  hypodermically  as 
heart  stimulants,  and  should  be  injected  deeply  into 
the  muscular  tissues  to  avoid  irritation  and  formation 
of  abscesses. 

^Ethylis  Bromidum. 

Ethyl  Bromide. 

Bromide  of  Ether.    Not  official. 

Made  by  distilling  together  alcohol,  sulphuric  ether, 
and  potassium  bromide.  It  is  colorless,  volatile,  and 
highly  inflammable.  Ethyl  bromide  is  used  as  a  gen- 
eral anaesthetic  in  short  operations,  or  before  beginning 
chloroform  anaesthesia.  It  is  administered  by  means 
of  a  mask,  as  in  giving  ether.  Anaesthesia  lasts  on  an 
average  for  a  minute  and  a  half  with  one  administra- 
tion of  the  anaesthetic.  Consciousness  returns  more 
quickly  than  from  any  other  anaesthetic,  but  the  inhala- 
tion is  not  pleasant  and  patients  complain  of  great  de- 
pression and  discomfort  afterwards.  Ethyl  bromide  is 
liable  to  decomposition  when  kept  long  and  is  often 
furnished  in  impure  form.  It  ought  to  be  perfectly 
colorless,  as  a  yellow  color  indicates  decomposition, 
often  with  the  presence  of  free  bromine.  The  in- 
halation of  from  one  to  six  drachms  should  give  the 
desired  result. 


140  MATERIA    MEDICA    FOR   NURSES. 


Chloridum. 
Ethyl  Chloride. 

A  highly  inflammable  gas  at  the  ordinary  room 
temperature,  it  must  never  be  used  near  a  fire.  It 
may  easily  be  liquefied,  and  is  used  both  as  a  general 
and  a  local  anaesthetic.  In  obstetrics  and  in  dentistry 
it  may  take  the  place  of  chloroform  or  of  nitrous  oxide, 
and  it  may  be  used  preliminary  to  the  administration 
of  ether  or  chloroform.  The  liquid  comes  in  sealed 
glass  tubes  with  capillary  points  which  are  to  be  broken 
off  or  unscrewed  when  the  liquid  is  volatilized  by  the 
warmth  of  the  hand.  The  stream  is  directed  upon  the 
point  desired  in  local  anaesthesia,  the  tube  being  held 
a  few  inches  away.  Anaesthesia  is  usually  effected  in 
fifteen  to  twenty  seconds.  It  should  not  be  applied  so 
long  that  the  tissues  are  frozen  hard,  but  should  be 
removed  as  soon  as  they  appear  white.  Too  much 
freezing  may  cause  delayed  healing  or  a  slough. 

Chloral. 

Chloral  is  an  oily,  colorless  fluid,  made  by  the  action 
of  chlorine  on  alcohol.  It  is  not  used  in  medicine. 
United  with  water  it  forms  a  hydrate  which  is  the 
hydrated  chloral  of  the  U.  S.  P. 

Chloralum  Hydratum. 
Hydrated  Chloral. 

Colorless,  volatile  crystals  of  hot,  burning  taste  and 
pungent  odor;  readily  soluble  in  water,  ether,  or  alcohol. 

Physiological  Actions. 

Chloral  has  antiseptic  properties  and  has  been  so 
used  in  a  strength  of  gr.  v.-  §  i.  of  water.  A  concen- 
trated solution  vesicates  and  is  very  painful. 

Given  internally  it  acts  on  the  nerve  centres  as  a 
sedative,  its  effect  on  the  brain,  under  suitable  condi- 
tions, being  that  of  a  pure  and  perfect  hypnotic.  The 


THE  CARBON  COMPOUNDS.  141 

sleep  it  causes  resembles  natural  sleep,  coming  on 
quickly  and  lasting  for  six  or  seven  hours.  The 
patient  may  be  aroused  from  it  for  medicine  or  nourish- 
ment, and  falls  asleep  again,  finally  awaking  refreshed 
and  without  headache  or  the  unpleasant  after-effects — 
such  as  nausea,  giddiness,  and  constipation — which  are 
commonly  found  after  taking  opium.  Even  if  given 
for  a  long  time  chloral  is  not  apt  to  cause  constipation 
or  disturbance  of  the  stomach. 

In  the  sleep  of  chloral  the  pupil  is  slightly  con- 
tracted, the  pulse  unaltered  or  a  little  slower  than 
normal,  the  respirations  regular,  full,  and  quiet.  The 
cases  in  which  its  beneficial  action  is  best  seen  are 
cases  of  insomnia  from  mental  labor,  anxiety,  or 
fatigue.  It  is  not  an  anodyne,  having  no  power  to 
overcome  pain  unless  given  in  dangerous  doses.  If  so 
given  the  after-effects  are  bad. 

The  action  of  chloral  is  not  always  satisfactory. 
With  some  persons  headache,  excitement,  and  even 
delirium  are  caused  by  medicinal  doses.  It  is  pre- 
eminently a  great  depressant. 

Symptoms  of  Poisoning'. 

In  larger  doses  the  respiratory  centre  is  depressed 
and  the  respirations  become  slow,  irregular,  and  shal- 
low. The  activity  of  the  vasomotor  centre  is  lessened, 
so  that  the  vessels  dilate  generally,  and  the  heart  is 
depressed  and  weakened  not  only  through  the  centre 
in  the  medulla  but  also  by  a  direct  influence  on  its  owu 
nerve  ganglia. 

The  pulse  becomes  weak  and  slow;  in  toxic  doses  it 
grows  rapid  and  irregular,  and  in  fatal  cases  feeble  and 
thready,  while  other  symptoms  are  coma,  great  muscu- 
lar relaxation,  pupils  at  first  contracted,  afterwards 
dilated;  and  death  results  from  paralysis  of  the  respira- 
tions and  heart. 

Treatment  of  Poisoning. 

The  treatment  in  chloral  poisoning  consists  in  the 
use  of  alcoholic  stimulants,  strong  coffee,  galvanism, 


142  MATERIA  MEDIC  A  FOR  NURSES. 

and  artificial  respiration.  The  application  of  external 
heat  is  of  the  utmost  importance.  Mustard  pastes  and 
hot  mustard  foot-baths  may  be  used,  avoiding,  how- 
ever, all  measures  which  might  exhaust  the  patient. 

Incidental  Effects. 

There  may  be  noticed  after  ordinary  doses  of  chloral, 
dyspnoea;  redness  and  swelling  of  the  conjunctivae;  and 
eruptions  of  the  skin,  most  frequently  a  simple  erythema 
which  seems  to  follow  preferably  the  course  of  the  large 
nerve  trunks.  Sometimes  the  eruption  takes  the  form 
of  wheals,  and  a  papular  eruption  has  also  been  ob- 
served. These  disorders  are  often  attended  by  some 
rise  of  temperature,  and  desquamation  sometimes  re- 
sults. It  is  supposed  that  they,  as  well  as  the  more 
alarming  ill  effects  of  chloral,  are  greatly,  if  not  alto- 
gether, due  to  impurities  in  the  drug. 

The  great  danger  of  chloral  is  the  sudden  paralysis 
of  the  heart,  which  may  occur  even  after  ordinary 
medicinal  doses,  and  without  warning.  This  attaches 
so  much  uncertainty  to  its  action  that  it  is  impossible 
to  express  caution  too  strongly  in  regard  to  using  it 
without  orders.  The  patient  may  be  sleeping  quietly, 
but  suddenly  becomes  restless  and  passes  into  a  state 
of  syncope.  The  danger  cannot  be  considered  past 
until  from  60  to  100  pulse  beats  can  be  counted  con- 
tinuously without  any  irregularity  in  strength. 

The  habitual  use  of  chloral  may  become  a  disorder 
almost  as  grave  as  the  opium  habit.  Those  who  have 
formed  this  habit  are  usually  excitable  in  manner; 
hurried  and  voluble  in  speech;  nervous  and  wakeful  at 
night;  melancholy  and  low-spirited  during  the  day, 
and  subject  to  vertigo  and  ringing  in  the  ears.  The 
eyes  are  brilliant  and  restless;  the  appetite  capricious 
or  lacking  altogether;  digestion  disordered;  the  heart 
action  weak  and  irregular;  and  the  secretion  of  bile 
deficient. 

Average  dose,  gr.  viii.-o.5  Gm.,  diluted  only  mod- 
erately with  water  or  a  weak  syrup. 


THE  CARBON  COMPOUNDS.  143 

Butyl  Chloral  Hydrate. 
Croton  Chloral.    Not  official. 

A  crystalline  body  formed  by  the  action  of  chlorine 
on  aldehyde;  sparingly  soluble  in  water,  readily  so  in 
glycerin.  It  is  said  to  resemble  chloral  in  its  action, 
but  to  be  more  depressing  and  less  efficient.  A  feebler 
poison,  more  disagreeable  in  taste,  and  having  a  special 
anaesthetic  effect  on  the  fifth  nerve. 

Average  dose,  gr.  v.-o-3  Gm.,  in  syrup  or  glycerin. 

Metachloral.  Not  official. 

A  solid  substance  prepared  by  acting  on  chloral 
hydrate  with  sulphuric  acid,  and  used  as  a  counter- 
irritant  and  local  anaesthetic. 

Chloral  Camphor.    Not  official. 

Equal  parts  of  camphor  and  chloral,  used  as  an  ex- 
ternal application  for  the  relief  of  pain. 


Paraldehydum,  Paraldehyde. 

Paraldehyde  is  a  colorless  liquid  solidifying  below 
50°  F.,  and  soluble  in  ten  parts  of  water.  It  has  a 
strong  ethereal  odor  and  unpleasant  taste.  It  is  a 
pure  hypnotic,  like  chloral,  having  about  half  its 
power  and  many  of  its  qualities  without  the  dangers 
of  chloral. 

In  its  action  the  cerebrum  is  first  affected,  and  sleep 
induced  with  no  primary  stage  of  excitement.  The 
medulla  is  next  affected,  and  next  the  spinal  cord.  It 
has  little  or  no  control  over  pain.  In  medicinal  doses 
it  is  not  paralyzing  to  the  heart,  and  does  not,  as  a  rule, 
leave  headache  or  unpleasant  after-effects. 

It  is  irritant  to  mucous  membrane,  and  is  likely  in 
time  to  impair  digestion.  It  gives  an  unpleasant  odor 
to  the  breath,  and  if  used  for  a  long  time  it  may  produce 
nasal  ulcers,  cerebral  congestion,  and  vasomotor  paraly- 
sis. It  sometimes  causes  erythema  or  reddening  of  the 


144  MATERIA    MEDICA    FOR  NURSES. 

skin.     Average  dose,  TT|,  xxx.-2  mils,  in  water,  either 
plain  or  with  simple  syrup.     It  must  be  well  diluted. 

Sulphonmethanum,  Sulphonal. 

Sulphonal  is  an  alcohol  derivative,  belonging  to  what 
are  chemically  known  as  the  sulphur  compounds  of 
alcohol.  It  has  hypnotic  action.  It  is  a  white,  odor 
less,  and  tasteless  powder,  almost  insoluble  in  water, 
requiring  from  100  to  150  parts  of  cold,  and  18  or  20 
of  boiling,  water  to  dissolve  it. 

In  favorable  instances  it  produces  a  physiological 
sleep,  which  lasts  for  several  hours,  with  no  unpleasant 
after-effects.  With  susceptible  cases  sleep  has  been 
known  to  come  on  in  an  hour  or  little  over,  but  as  a 
usual  thing  sulphonal  is  rather  slow  in  action,  sometimes 
not  taking  effect  for  several  hours,  sometimes  even  not 
until  the  next  day;  and  in  these  delayed  cases,  sleep, 
when  it  does  come,  is  prolonged  and  dull.  In  a  certain 
number  of  cases  sulphonal  fails  to  act  satisfactorily, 
and,  in  these,  nausea,  mental  excitement,  vomiting, 
dizziness  and  staggering,  headache  and  depression  have 
been  observed  after  its  use. 

It  may  be  given  dry  on  the  tongue,  but  is  best  given 
in  hot  milk,  or  soup,  or  beef- tea,  with  plenty  of  salt. 
L,arge  amounts  of  warm  fluids  favor  its  absorption,  and 
as  it  is  often  slow  in  action  it  is  better  given  early  in 
the  evening.  Average  dose,  gr.  xii.-o.ys  Gm. 

Hypnone.     Not  official. 

A  hypnotic,  produced  chemically  as  a  derivative 
of  alcohol.  A  colorless  liquid  having  a  strong  odor 
of  almond  or  orange.  It  is  not  dangerous,  and  leaves 
no  ill  after-effects  except  a  disagreeable  odor  to  the 
breath. 

Average  dose,  gr.  V.-O.3  Gm.,  in  capsule,  being 
insoluble  in  water. 


THE  CARBON  COMPOUNDS.  14$ 

Urethan.    Not  official. 

A  combination  of  carbonic  acid  and  ethylic  ether, 
sometimes  used  as  a  hypnotic.  Its  action  is  rather 
uncertain,  and  resembles  paraldehyde.  It  has  no 
power  over  pain,  is  not  depressing  or  irritating  to  the 
stomach,  and  under  favorable  circumstances  has  in- 
duced sleep  in  15  or  20  minutes,  and  prolonged  it  for  6 
or  8  hours.  It  is  soluble  in  water,  and  may  be  given 
hypodermically,  as  it  is  not  irritating. 

Average  dose,  gr.  viii.-o.5  Gm.,  best  given  in  pellet, 
wafer,  or  capsule. 

Amylene  Hydrate.    Not  official. 

An  alcohol  derivative,  with  properties  as  a  hypnotic, 
its  power  being  considered  intermediate  between  chloral 
and  paraldehyde.  It  is  a  clear  liquid,  soluble  in  8  parts 
of  water,  and  readily  so  in  alcohol.  It  is  agreeable  to 
the  taste  and  not  dangerous,  having,  in  medicinal  doses, 
no  depressing  effect.  Very  large  doses  paralyze  the 
respiratory  centre,  and  also  the  heart. 

Average  dose,  TT[  xxx.-2  mils. 

Amylis  Nitris,  Amyl  Nitrite. 

Amyl  nitrite  is  produced  by  distilling  nitric  acid  with 
amylic  alcohol  (fusel  oil),  sulphuric  acid,  and  copper, 
and  purifying  with  alkalies  by  various  intricate  pro- 
cesses. An  ethereal  liquid  of  yellow  color  and  fruity 
odor. 

It  is  given  by  inhalation  usually.  The  vapor  enters 
the  blood  through  the  lungs  with  extreme  rapidity, 
reaching  the  tissues  and  producing  its  characteristic 
effects  almost  instantaneously. 

Amyl  nitrite  is  a  motor  depressant.  Its  leading 
physiological  action  is  upon  the  spinal  cord  and  the 
circulation,  other  effects  being  secondary.  The  motor 
centres  in  the  cord  are  directly  and  strongly  depressed, 
and  a  similar  but  less  powerful  action  is  exerted  on  the 


146  MATERIA  MEDIC  A   FOR  NURSES. 

motor  nerves  and  muscles.  The  sensory  nerves  are  but 
little  affected. 

Two  effects  are  produced  on  the  circulation.  First, 
the  muscular  walls  of  the  arteries  are  paralyzed;  the 
vessels  dilate,  and  the  blood  pressure  falls.  Second, 
by  this  reduction  of  the  blood  pressure  the  resistance 
which  was  met  by  the  left  ventricle  in  discharging  its 
contents  disappears,  with  consequent  relief  to  the  heart, 
which  has  at  once  less  work  to  do,  with  the  same,  or  in- 
creased, strength  to  do  it.  The  heart-beats  are  increased 
in  number — not  always  in  force, — and  the  depression 
of  the  inhibitory  apparatus  gives  the  beats  an  energetic 
and  thumping  character. 

In  this  way  amyl  nitrite  acts  as  a  heart  stimulant, 
not  by  actually  strengthening  the  heart  itself,  but  by 
clearing  away  obstructions  to  a  free  circulation  which 
increased  the  work  of  the  heart  and  exhausted  it  by 
compelling  it  to  put  forth  abnormal  exertions. 

From  2  to  5  drops,  inhaled,  will  give  this  result,  with 
the  attendant  symptoms  of  fulness  and  throbbing  of  the 
head,  amounting  sometimes  to  severe  pain. 

If  inhalation  is  carried  beyond  this  there  will  be 
vertigo;  flushing  of  the  face,  with  visible  pulsation 
of  the  carotids;  deep,  labored  respiration;  tingling  of 
the  surface;  dilatation  of  the  pupils;  restlessness  and 
anxiety.  These  symptoms  disappear  rapidly  on  the 
withdrawal  of  the  drug,  and  the  heart-beats  fall  to 
normal. 

It  is  stated  that  all  objects  look  yellow  to  one  fully 
under  the  influence  of  amyl  nitrite. 

Larger  doses  increase  all  these  symptoms  in  severity, 
to  the  point  of  grave  depression,  with  cold  extremities; 
heavy,  clammy  perspiration;  slow,  almost  impercep- 
tible pulse;  irregular  respirations;  and  severe  persistent 
headache.  There  may  sometimes  be  convulsions. 
Toxic  doses  paralyze  the  heart  and  respiratory  centres. 
In  cases  of  poisoning  by  amyl  nitrite  all  the  blood  of 
the  body  becomes  a  uniform  hue,  which  is  described 
as  being  nearer  a  chocolate  color  thai*  ordinary  venous 
blood. 


THE  CARBON  COMPOUNDS. 

The  poisonous  dose  is  not  certainly  known.  A  des- 
sert-spoonful taken  internally  has  been  recovered  from, 
by  the  aid  of  emetics,  and  hypodermically  3  ii.  have 
been  given  in  an  hour  and  a  half  without  unpleasant 
symptoms. 

In  giving  inhalations  of  amyl  nitrite,  from  i  to  3 
drops  are  placed  on  a  handkerchief,  or  piece  of  lint  or 
cotton,  held  near  the  nose,  and  withdrawn  as  soon  as 
fulness  in  the  head  or  flushing  of  the  face  is  produced. 
The  symptoms  usually  are  a  little  more  prominent  for 
a  moment  or  two  after  the  drug  has  been  withdrawn. 
It  has  been  given  hypodermically  and  also  by  mouth. 
In  the  latter  way  the  dose  is  iri  i.-ii.  on  sugar.  Amyl 
nitrite  is  inflammable. 

Amyl  nitrite  escapes  by  the  kidneys.  The  urine  is 
increased  in  amount  and  in  acidity,  and  may  sometimes 
contain  sugar. 

Nitro  Glycerinum,  Nitro  Glycerin,  Trinitrin, 
Glonoin.    Not  official. 

Made  by  dropping  glycerin  in  a  mixture  of  sulphuric 
and  nitric  acids  kept  ice-cold;  separating  by  pouring 
the  product  into  water,  washing,  and  evaporating  to  a 
proper  density.  A  colorless,  oily  liquid,  odorless,  with 
sweet,  pungent  taste;  slightly  soluble  in  water  and 
freely  so  in  oils,  alcohol,  and  ether. 

If  heated  in  a  close  vessel,  or  if  subjected  to  per- 
cussion, it  will  explode.  Mixed  with  porous  silica, 
nitre-glycerin  constitutes  dynamite.  It  is  never  used 
undiluted  in  medicine.  If  spilled  on  the  floor  it  may 
be  dangerous.  Pour  potassium  hydroxide  on  it  to 
cause  decomposition. 

Spiritus  Glycerilis  Nitratis. 
Spirit  of  Glyccryl  Trinitratc. 
Spirit  of  Nitroglycerin. 

A  one-per-cent.  alcoholic  solution  of  glyceryl  trini- 
trate.  It  should  be  kept  cool,  away  from  lights  or  fire. 


148  MATERIA  MEDIC  A  FOR  NURSES. 

Physiological  Actions. 

Nitro-glycerin  is  the  most  powerful  of  the  nitrites. 
Its  physiological  actions  resemble  very  strongly  those 
of  amyl  nitrite  but  in  a  greater  degree,  and  the  effects, 
while  less  prompt  in  appearing,  are  more  lasting,  being 
developed  in  from  three  to  five  minutes,  and  continuing 
for  about  forty-five  minutes. 

Depression  of  the  motor  centres,  dilatation  of  the 
blood-vessels,  and  lowering  of  the  blood  pressure  are 
the  chief  factors  in  the  action  of  nitro-glycerin.  The 
first  signs  manifest  are  perspiration  and  quickened 
heart  action,  with,  sometimes,  a  dicrotic  pulse;  dis- 
turbed respiration,  flushed  face,  vertigo,  constriction 
of  the  head  and  throat,  occasional  nausea,  throbbing  of 
the  carotids,  and  headache,  which  is  of  a  severe  frontal 
type,  and  lasts  sometimes  for  hours  after  other  effects 
have  worn  away.  In  some  cases  albumin  in  the  urine 
is  diminished  by  nitro-glycerin. 

Symptoms  of  Poisoning. 

Poisonous  doses  cause  heart  failure,  with  slow,  inter- 
mittent, and  very  irregular  pulse;  dilated  pupils;  a 
feeling  of  weakness  in  the  epigastrium;  and  intense 
headache,  with  a  feeling  as  of  a  tight  band  around  the 
head. 

Symptoms  of  poisoning  not  resulting  in  death  have 
followed  doses  of  from  two  to  ten  drops  of  the  alcoholic 
solution. 

Nitro-glycerin  is  given  in  tablets,  or  in  the  form  of 
the  alcoholic  solution,  strength  i  per  cent.  This  prep- 
aration should  be  constantly  renewed,  as  it  decom- 
poses with  age.  In  the  case  of  an  unconscious  patient 
it  may  be  dropped  on  the  back  of  the  tongue.  Average 
dose,  iT[  i.-o.o5  mil,  in  a  little  glycerin. 

Phenol,  Carbolic  Acid. 

Phenol  is  a  product  of  the  distillation  of  coal  tar.  It 
may  also  be  obtained  by  the  distillation  of  other  organic 


THE  CARBON  COMPOUNDS.  149 

substances,  and,  finally,  may  be  made  artificially — 
synthetic  carbolic  acid.  Crude  phenol  is  an  imperfectly 
purified  article,  the  result  of  two  distillations.  It  is  a 
dark-reddish  liquid,  useful  as  a  disinfectant,  and  cheap. 
Further  distillations  produce  pure  phenol,  which  is 
colorless,  crystallizes  in  needles,  and,  if  absolutely  pure, 
does  not  absorb  water  from  the  air. 

If  5  to  10  %  of  water  be  added  to  the  melted  crystals, 
phenol  will  remain  clear  and  not  recrystallize  on  cool- 
ing; the  further  addition  of  water  will  cause  a  separa- 
tion, phenol  going  to  the  bottom  as  an  oily  layer,  the 
mixture  not  becoming  clear  again  until  90  to  95  %  of 
water  has  been  added.  The  standard  solution  for 
ward  use  is  made  i  part  in  20  parts  of  water.  The 
phenol  and  water  should  be  well  mixed,  as  they  do  not 
readily  combine.  Phenol  is  freely  soluble  in  glycerin, 
alcohol,  and  ether.  It  sometimes  acquires  a  reddish 
color  on  exposure,  said  to  be  due  to  minute  quantities 
of  metal,  probably  copper,  contained  in  traces  of  the 
tar  products  present. 

Physiological  Effects. 

Phenol  applied  locally  is  antiseptic,  irritant,  and 
anaesthetic.  In  concentrated  form  it  is  a  severe 
caustic.  The  vapor,  internally,  is  stimulant  and  dis- 
infectant. Taken  into  the  stomach,  the  acid  arrests 
fermentative  changes,  and  in  large  doses  is  a  powerful 
irritant  and  narcotic  poison,  acting  on  the  respiratory 
and  vasomotor  centres,  which  it  quickly  paralyzes.  It 
is  rapidly  absorbed  by  the  unbroken  skin,  the  sub- 
cutaneous tissues,  the  mucous  surfaces,  wounds,  the 
respiratory  passages,  and  the  stomach, and  is  excreted 
by  the  urine,  to  which  it  gives  a  dark,  smoky,  or  green- 
ish color;  also  by  the  saliva,  which  is  increased  in 
quantity. 

Phenol  is  a  deodorizer  and  disinfectant  as  well  as 
an  antiseptic.  It  is  very  destructive  to  low  forms  of 
life  if  used  in  sufficient  strength,  but  in  solutions  of  a 
strength  which  may  be  safely  used  externally,  as  in 
the  dressing  of  wounds,  or  applications  to  skin  or 


150  MATERIA   MEDICA    FOR  NURSES. 

membrane,  it  only  prevents  the  development  of  germs, 
and  does  not  kill  their  spores.  Used  constantly,  as  in 
dressings,  even  dilute  phenol  will  produce  in  time  a 
gangrenous  condition. 

Symptoms  of  Poisoning. 

The  first  signs  of  poisoning  from  the  use,  either  ex- 
ternal or  internal,  of  phenol,  are :  giddiness,  tension  of 
the  head,  and,  usually,  the  dark  color  of  the  urine. 
More  serious  evidences  of  danger  are :  contracted 
pupils;  pallor;  embarrassed  breathing;  a  small,  slow, 
feeble  pulse;  ringing  or  singing  in  the  ears;  and  sud- 
den vertigo. 

When  swallowed  in  poisonous  doses  there  is  at  once 
a  hot  burning  sensation  from  mouth  to  stomach,  and 
the  symptoms  come  on  immediately.  The  lips  and 
lining  of  the  mouth  are  white  and  hardened;  there  is 
nausea,  with  violent  pain  and  vomiting  of  frothy 
mucus;  the  lips,  ears,  and  eyelids  are  livid;  the  pupils 
contracted  and  insensible  to  light.  The  skin  is  cold 
and  covered  with  clammy  perspiration;  the  pulse  very 
feeble  and  almost  always  rapid, — 120 — though  it  has 
been  known  to  fall  to  40  or  50  a  minute;  the  respirations 
are  rapid,  irregular,  and  difficult,  sometimes  stertorous, 
sometimes  gasping,  and  the  breath  has  the  odor  of  the 
acid.  Insensibility,  coma,  and  collapse  follow  quickly 
in  succession,  and  death  may  occur  within  a  few 
minutes  from  paralysis  of  the  respiration,  or,  if  a  very 
large  amount  has  been  taken,  from  paralysis  of  the 
heart.  The  average  time  of  death  is  between  one  and 
ten  hours,  and  the  fatal  dose  may  range  from  3  i.  to 
§  ss.  (4-16  Gm.) 

Treatment  of  Poisoning. 

In  the  treatment  of  this  poison  emetics  are  not  al- 
ways of  use,  owing  to  a  paralyzed  condition  of  the 
stomach,  and  the  stomach-pump  should  be  used,  wash- 
ing out  the  stomach  with  50  %  alcohol.  The  chemical 
antidotes  are  sulphate  of  magnesia  or  of  soda,  or  syrup 


THE  CARBON  COMPOUNDS.  I$I 

of  lime,  and  they  should  be  freely  given  (  |  iii.  of  the 
sulphates  have  been  given)  as  long  as  the  patient  can 
swallow,  or  until  there  is  improvement.  Lime  water 
and  milk  in  equal  parts  may  be  given,  and  vegetable 
demulcents — as  flaxseed  tea, — but  no  oils  or  glycerin,  as 
they  dissolve  the  acid  and  aid  its  absorption.  Atropine 
is  a  physiological  antagonist,  maintaining  respiration; 
and  cardiac  stimulants  may  be  required,  given  hypoder- 
mically. 

Phenol  is  in  general  use  as  an  antiseptic  and  disin- 
fectant, though  the  manner  of  its  employment  has  been 
greatly  modified  and  changed  in  some  respects  from 
that  of  former  years.  For  the  practical  work  of  the 
nurse  in  cleaning  and  disinfecting  it  stands  high,  and 
is  used  in  a  strength  cf  i  in  20  or  i  in  40.  Articles  to 
be  disinfected,  viz.  soiled  clothing,  sputum  cups,  etc., 
must  soak  in  it  for  varying  lengths  of  time,  according 
to  the  nature  of  the  case. 

Phenol  may  be  used  for  clothing,  as  it  does  not  stain. 
In  the  sick-room  its  strong  odor  makes  it  unpleasant 
to  many  persons,  and  this  odor  may  be  covered  by  using 
oil  of  peppermint  or  cinnamon. 

Average  dose,  gr.  i.-o.o6  Gm.,  in  glycerin  or  simple 
syrup — well  diluted. 

There  is  a  large  and  constantly  increasing  group  of 
compounds  allied  to  phenol,  called  cresols.  They  are 
derived  from  coal  tar,  and  possess  strong  antiseptic  and 
germicidal  powers.  As  a  rule,  they  are  less  poisonous 
than  phenol.  Among  them  may  be  mentioned  creolin, 
lysol,  saprol,  sozal,  chlorphenol,  pheno-salyl,  aseptol, 
etc.  The  well-known  Dobell'  s  solution  contains  phenol, 
sodium  bicarbonate,  borax,  and  glycerin. 

Creosotum,  Creosote. 

Creosote  is  produced  by  the  distillation  of  wood  tar, 
and  is  a  very  complex  substance,  containing  many 
hydro-carbons,  some  of  which  are  closely  related  to 
phenol.  Creosote  is  not  as  poisonous  as  phenol,  nor  so 
active  as  a  germicide  and  antiseptic,  but  many  of  ite» 


I  $2  MATERIA  MEDIC  A   FOR  NURSES. 

physiological  properties  are  similar,  and  its  value  me- 
dicinally is  about  the  same,  though  it  is  oftener  used. 
^  It  is  a  stimulant,  expectorant,  and  gastric  seda- 
tive. In  the  stomach  it  checks  fermentation,  yet  does 
not  interfere  with  digestion.  The  vapor  is  disinfec- 
tant and  deodorant.  When  inhaled  it  is  stimulant, 
and  when  ordered  in  this  way  it  is  convenient  to  use  a 
small  cone,  which  may  be  easily  improvised. 

Only  a  few  cases  of  poisoning  are  recorded.     The 
symptoms  and  treatment  are  like  those  of  phenol. 
Average  dose,  TTI,  iii.-o.2  mils. 

Aqua  Creosoti. 
Creosote  Water. 

Strength,  i  per  cent.     Dose,  3  i.-ii.    4-8  mils. 
Guaiacol. 

Obtained  by  distilling  beechwood-tar  creosote,  or  by 
preparing  synthetically. 

Derivatives  of  guaiacol :  the  first  only  official. 

Guaiacolis  Carbonas 

Benzosol. 

Styracol. 

Acidum  Salicylicum,  Salicylic  Acid. 

Salicylic  acid  is  prepared  synthetically  by  treating  a 
solution  of  carbolic  acid  in  caustic  soda  with  carbonic 
acid,  at  a  moderate  heat.  It  is  also  found  in  nature  in 
oil  of  wintergreen,  in  sweet  birch,  and  in  the  bark  of 
several  varieties  of  willow.  A  dull  white  powder, 
readily  soluble  in  alcohol  and  glycerin,  but  almost  in- 
soluble in  cold  water.  In  hot  water  it  is  more  readily 
dissolved,  and  borax  and  boric  acid  assist  the  solvent 
action. 

Physiological  Actions. 

Salicylic  acid  is  an  antiseptic  and  disinfectant.  If 
is  a  diaphoretic  and  antipyretic  in  fever,  but  doe? 


THE  CARBON  COMPOUNDS.  1 53 

not  lower  the  temperature  in  health.  It  is  not  much 
used  in  this  way,  as  other  antipyretics  are  more  lasting 
in  influence  and  less  depressing  than  salicylic  acid. 

After  an  antipyretic  dose  there  is  slight  temporary 
stimulation  of  the  heart;  the  face  and  eyes  are  suffused 
and  there  is  a  feeling  of  warmth,  followed  by  perspira- 
tion. These  effects  are  visible  in  ten  or  fifteen  minutes, 
and  following  them  there  is  a  reduction  of  the  strength 
of  the  heart. 

Salicylic  acid  has  a  stimulant  and  disinfectant  action 
on  the  kidneys  and  urinary  apparatus,  and  increases 
the  acidity  of  the  urine.  In  some  cases  it  irritates  the 
kidneys  and  causes  hsematuria  or  albuminuria. 

In  small  doses  it  stimulates  digestion,  the  heart, 
and  respiration,  but  in  large  doses  it  depresses  the  last 
two,  lowers  arterial  tension,  and  causes  nausea  and 
vomiting. 

Incidental  Effects. 

In  giving  salicylic  acid  the  first  evidences  of  over- 
dosing which  are  to  be  looked  for  are  buzzing  and 
roaring  in  the  ear,  and  fulness  of  the  head.  Increased 
doses  bring  severe  headache,  perspiration,  deafness, 
and  various  disturbances  of  vision;  and,  if  still  con- 
tinued, these  symptoms  are  all  intensified.  The  respi- 
rations become  deeper  and  are  labored,  rapid,  and 
irregular  —  sometimes  the  most  violent  respiratory 
efforts  being  made  to  overcome  the  dyspnoea ;  the 
pulse  is  slow  and  weak,  and  there  is  a  great  restless- 
ness, with  a  delirium  characterized  by  hallucinations 
of  vision,  and  which  is  sometimes  cheerful,  sometimes 
melancholy,  and  sometimes  wildly  maniacal.  The 
urine  may  be  dark  olive-green,  and  involuntary  evacu- 
ations of  the  bowels  may  take  place. 

The  depression  of  the  circulatory  system  causes  a 
relaxed  state  of  the  skin,  and  bed-sores  are  liable  to 
appear  rapidly.  Eruptions  of  the  skin,  somewhat  re- 
sembling that  of  urticaria,  may  appear  even  after 
medicinal  doses. 

Salicylic  acid  is  not  considered  an  active  poison  to 


154  UATERIA    MEDIC  A    FOR   NURSES. 

man.  Cases  of  death  from  its  use  have  been  recorded, 
but  they  are  not  all  well  verified.  As  a  preservative 
in  canned  foods  it  acts  as  a  slow  poison  and  as  such  it 
is  even  more  dangerous. 

Salicylic  acid  is  transformed  in  the  blood  into  salicy- 
late  of  sodium,  and  is  slowly  excreted  by  the  urine, 
perspiration,  saliva,  bile,  and  mucous  secretions. 

Average  dose,  gr.  xii.-o.75  Gm.,  moderately  diluted. 

Sodii  Salicylas. 
Sodium  Salicylate. 

Made  by  the  action  of  salicylic  acid  on  carbonate  of 
sodium.  It  is  readily  soluble  in  water;  has  the  same 
physiological  actions  as  salicylic  acid,  and  is  less  irrita- 
ting. It  has  no  antiseptic  qualities  in  external  use.  It 
is  considered  a  specific  in  rheumatism,  and  in  giving  a 
course  of  it  the  same  incidental  symptoms  mentioned 
under  salicylic  acid  are  to  be  looked  for. 
Average  dose,  gr.  xv.-i  Gm.,  moderately  diluted. 


Phenylis  Salicylas. 
Phenyl  Salicylate. 
Salol. 

A  preparation  composed  of  two  thirds  salicylic  and 
one  third  carbolic  acids.  It  is  insoluble  in  water  and 
is  given  in  compressed  tablets. 

Salol  is  antiseptic  and  antipyretic;  sedative  to 
the  brain  and  spinal  cord,  and  with  some  power  as  an 
analgesic.  It  is  an  active  diaphoretic,  and  though 
in  some  cases  it  has  a  somewhat  depressing  effect,  yet 
its  action  is  usually  not  marked  by  as  much  exhaustion 
as  that  of  many  of  the  new  antipyretics,  and  when  the 
temperature  rises  after  being  reduced  by  salol,  it  does 
so  without  chill  or  chilly  feelings.  Its  physiological 
effects  and  medicinal  uses  are  in  general  very  like  those 
of  salicylic  acid.  It  is  not  considered  poisonous,  and 
is,  like  iodoform,  used  as  a  topical  application. 

Average  dose,  gr.  v.-o.3  Gm. 


THE  CARBON  COMPOUNDS.  I$5 

Materia 


aultheri*. 
Thiersch  Powder. 

A  combination  of  salicylic  and  boric  acids,  usually 
ordered  in  the  proportion  of  |  ss.  of  the  latter  to  3  ss. 
of  the  former.  Added  to  o*  e  quart  of  water  it  forms 
an  antiseptic  solution,  of  moderate  power,  which  is  not 
irritating  or  poisonous  when  freely  used.  The  propor- 
tions of  a  Thiersch  powder  are  not  invariable,  as  Prof. 
Thiersch  did  not  confine  himself  to  one  formula.1 

Theobrominae  Sodio-Salicylas. 
Theobromine  Sodio-Salicylate. 

Made  from  theobromine,  an  alkaloid  obtained  from 
the  seeds  of  Theobroma  cacao,  the  chocolate  tree  of  South 
America,  and  sodium  salicylate.  It  is  a  white  powder, 
soluble  in  half  its  weight  of  warm  water.  As  the  theo- 
bromine separates  from  it  on  exposure  to  the  air,  it 
should  not  be  given  as  powder,  but  as  freshly  prepared 
aqueous  solution. 

Physiological  Actions. 

It  is  a  reliable  diuretic,  increasing  the  amount  of 
urine,  and  the  solids  excreted  by  the  urine.  Its  in- 
fluence over  the  amount  of  albumin  is  not  constant. 
However,  in  chronic  nephritis  the  amount  of  albumin 
is  generally  diminished.  In  dropsy,  with  the  increase 
of  urine,  there  is  disappearance  or  marked  improvement 
of  the  oedema.  Occasionally  a  profuse  diarrhoea  is  ap- 
parently produced  by  the  remedy,  and  assists  in  this 
removal  of  the  transudation. 

It  is  believed  that  the  drug  has  a  moderate  influence 
on  the  heart.  It  strengthens  and  regulates  it,  is  not 
depressing,  and  produces  no  functional  disturbance. 
It  does  not  appear  that  it  causes  any  irritation  either 
of  the  stomach  or  kidneys.  Its  diuretic  action  depends 
on  a  direct  influence  on  the  renal  epithelium. 

Average  dose,  gr.  viii.-o.5  mils. 

1  Charles  Rice,  Ph.D. 


I $6  MATERIA  MEDICA  FOR  NURSES. 

Naphthalenum,  Naphthalin. 

A  coal-tar  derivative  with  the  taste  and  odor  of  tar; 
insoluble  in  water,  soluble  in  ether,  hot  alcohol,  and 
benzol. 

It  is  antiseptic  and  destructive  to  low  forms  of  life. 
Internally  it  is  a  stimulant  expectorant,  and  acts  as 
a  disinfectant  to  the  alimentary  canal.  The  latter 
action  is  a  local  one,  as  it  is  not  readily  absorbed  into 
the  system,  but  is  mostly  carried  away  by  the  faeces, 
that  part  of  it  taken  up  by  the  blood  being  excreted 
by  the  urine  partly  unchanged  and  partly  as  naphtol. 
Externally  it  is  used  as  an  antiseptic. 

Betanaphthol. 
Naphthol. 

Derived  from  naphthalin  ;  soluble  in  alcohol,  ether, 
chloroform,  oil,  and  vaseline.  It  is  more  easily  ab- 
sorbed than  naphthalin,  and  causes  vomiting,  haema- 
turia,  convulsions,  and  unconsciousness.  In  medicinal 
doses  it  is  an  intestinal  disinfectant,  in  doses  of 
gr.  i.-iv.  (0.065-0.25  Gm.).  It  is  also  used  as  a  local 
application,  dissolved  in  alcohol,  in  from  i  to  50$. 

Allied  to  naphthol,  all  unofficial,  are: 

Microcidin.  Alumnol. 

BenzonaphthoL     Hydronaphthot 
Betol.  Asaprol. 

Chinolin.     Not  official. 

Chinolin  is  a  derivative  of  cinchona  bark,  from 
which  it  is  named,  and  is  also  found  in  coal-tar  oil. 
It  is  made  synthetically  by  the  action  of  glycerin  on 
nitro-benzol  and  aniline.  It  is  a  colorless,  oily  liquid, 
and  on  exposure  to  the  air  turns  dark.  Like  an  alka- 
loid, it  combines  with  acids  to  form  salts.  It  is 
antiseptic. 

The  taste  and  odor  are  very  disagreeable.  It  re- 
sembles quinine  somewhat  in  its  antipyretic  action. 


THE  CARBON  COMPOUNDS. 

After  a  full  dose  there  is  a  short  preliminary  stage  of 
excitement,  with  increased  pulse  and  a  feeling  of 
warmth,  followed  by  perspiration,  fall  of  temperature, 
slow  and  weak  pulse,  and  lessened  respirations.  In 
large  doses  it  diminishes  reflex  action  and  causes 
dyspnoea,  paralysis,  and  collapse.  Only  one  salt,  the 
tartrate,  is  used  medicinally. 

Chinolin  Tartras.   Not  official. 

Average  dose,  gr.  viii.-o.5  Gm.,  may  be  given  with 
peppermint  water. 

Chinolin  is  not  in  general  use,  and  is  here  placed  be- 
fore some  of  the  more  practically  important  antipyretics 
in  an  introductory  way.  Many  of  these  medicines, 
which  are  synthetically  prepared  in  laboratories,  are 
the  results  of  experiments  made  in  the  attempt  to  pro- 
duce an  imitation  of  quinine,  and  several  different  ones 
are  derived  from  chinolin. 

ANTIPYRETICS. 

These  drugs  are  supposed  to  act  upon  the  heat  regu- 
lating centre  of  the  body,  throwing  it  out  of  function, 
the  heat  then  accumulating  in  the  body  as  it  is  formed 
by  oxidation  and  other  processes,  until,  by  a  diffuse 
dilatation  of  the  blood-vessels,  the  body  loses  a  large 
amount  of  heat,  even  chills  and  rigors  with  possibly 
sweating  and  collapse  resulting.  Large  doses  of  these 
drugs  "lake"  the  blood,  break  up  the  red  blood  cells, 
and  form  methsemoglobin.  Cf.  Potassium  Chlorate,  p. 
42.  The  cyanosis  may  be  caused  partly  by  this,  partly 
by  the  dilated  blood-vessels,  and  partly  by  the  weak 
circulation  due  to  collapse.  The  drugs  so  acting  are 
antipyrine,  acetauilide,  resorcinol,  and  phenacetine. 

Antipyrina,  Antipyrine. 

Antipyrine  is  a  coal-tar  derivative,  being  prepared 
from  chinolin.  It  is  an  alkaloidal  body,  combining 
with  acids  to  form  salts.  A  whitish,  crystalline  powder 


158  MATERIA  MED  1C  A  FOR  NURSES. 

of  slightly  bitter  taste,  soluble  in  water  in  a  proportion 
of  ten  parts  to  six  parts  of  water. 

Physiological  Actions. 

When  first  introduced  it  was  a  proprietary  medicine 
and  was  known  principally  as  an  antipyretic.  With 
further  use  and  investigation  other  therapeutic  qualities 
have  been  manifested. 

It  is  a  general  nerve  sedative  and  anodyne,  having 
a  considerable  degree  of  power  in  the  relief  of  pain  in 
various  conditions  of  nervous  origin.  It  is  slightly 
antiseptic  and  disinfectant,  diaphoretic,  and  has 
some  diuretic  action.  It  is  also  credited  with  being  to 
some  extent  a  haemostatic.  Antipyrine  does  not  lower 
the  normal  temperature,  but  in  fever  its  action  is  very 
marked.  There  is  a  short  period  of  stimulation,  with 
flushing  of  the  face,  a  feeling  of  heat,  and  increased 
action  of  the  heart.  In  about  half  an  hour  or  more 
perspiration  breaks  out  and  usually  becomes  very  pro- 
fuse. The  pulse  is  then  slowed,  but  not  always  weak- 
ened. The  skin  is  cool;  there  may  be  chilly  feelings, 
and  the  temperature  falls  from  one  to  several  degrees, 
according  to  the  amount  taken,  and  remains  down  for 
a  length  of  time  also  proportioned  to  the  dose — usually 
two  or  three  hours,  and  often  longer. 

There  results  very  often — especially  in  subjects  weak- 
ened by  a  long  illness — a  decided  state  of  depression, 
sometimes  so  marked  as  to  be  alarming,  and  the  pulse, 
though  not  always  weakened,  is  in  some  cases  seriously 
so.  The  use  of  antipyrine  in  acute  illness  often  causes 
nausea  and  vomiting,  though  it  is  not  a  gastric  irritant 
in  any  special  sense,  but  in  small  doses  tonic,  increas- 
ing the  appetite.  Symptoms  which  indicate  danger  in 
giving  antipyrine  are  cyanosis,  muscular  weakness,  dis- 
turbed and  rapid  respirations,  weakened  irregular  pulse, 
dyspnoea,  and  sensations  of  heat  over  the  body.  Col- 
lapse may  result  from  its  use,  and  death  in  one  instance 
followed  the  administration  of  fifty-odd  grains.  An 
eruption  of  the  skin  frequently  occurs,  with  some  con- 
stitutional disturbance  and  considerable  suffering  and 


THE  CARBON  COMPOUNDS.  159 

annoyance  from  the  itching,  which  is  severe.  It  lasts 
for  several  days,  and  in  the  majority  of  cases  resembles 
the  measles  rash;  but  sometimes  appears  as  a  general 
and  intense  erythema,  with  swelling  of  the  face,  espe- 
cially about  the  eyes,  burning  sensations,  and  rise  of 
temperature.  Antipyrine  has  been  given  hypodermi- 
cally,  but  is  irritant  and  liable  to  cause  abscesses.  If 
so  given  it  should  be  injected  deeply  into  the  gluteal 
muscular  tissue. 

Average  dose,  gr.  v.-o.3  Gm.,  diluted  moderately. 
It  may  be  given  in  a  little  wine,  or  iced  brandy  and 
water. 

Acetanilidum,  Acetanilid. 
Antifebrin. 

A  neutral  substance  derived  from  aniline  by  the 
action  of  glacial  acetic  acid.  A  colorless  crystalline 
powder  of  slightly  burning  taste,  soluble  in  alcohol, 
but  not  readily  so  in  water. 

Its  medicinal  qualities  are  very  similar  to  those  of 
antipyrine,  it  being  antipyretic,  analgesic,  and  a 
nervous  sedative.  It  has  some  differences  of  action. 
It  diminishes  the  irritability  of  sensory  nerves,  lessens 
the  reflex  action  of  the  spinal  cord,  raises  arterial  ten- 
sion to  some  extent,  and  slows  the  heart  correspond- 
ingly. The  reduction  of  temperature  by  acetanilide 
takes  place  rather  more  slowly  than  that  caused  by 
antipyrine  —  sometimes  twice  as  much  time  being 
required. 

The  effects  last  longer — six  or  seven  hours — and  the 
fall  is  sometimes,  though  not  always,  accompanied  by 
perspiration  rather  less  profuse  than  that  produced  by 
antipyrine.  The  lowering  of  the  temperature  is  not 
supposed  to  depend  on  this  diaphoresis,  as  experiments 
show  that  one  sometimes  follows  without  the  other. 

The  antipyretic  action  of  acetanilide  is  occasionally 
followed  by  cyanosis,  and  in  rare  cases  by  collapse, 
though  it  is  usually  considered  less  apt  than  antipyrine 
to  produce  severe  depression,  and  in  the  majority  of 


160  MATERIA  MED  1C  A  FOR  NURSES. 

cases  its  use  leaves  no  ill  after-effects  and  does  not 
nauseate.  It  has  diuretic  action  and  is  a  cerebral 
stimulant,  while  antipyrine  depresses  the  brain.  A 
poisonous  dose  destroys  the  ozonizing  function  of  the 
blood. 

Incidental  effects  noticed  sometimes  after  its  use  are 
deafness,  ringing  in  the  ears,  dilatation  of  the  pupils, 
and  an  eruption  similar  to  that  caused  by  antipyrine. 

Average  dose,  gr.  iii.-o.2  Gm.  It  may  be  given  in 
dilute  alcoholic  solution,  and,  like  many  remedies  to- 
day, is  put  up  in  compressed  tablets. 

Allied  to  acetanilid,  all  unofficial,  are  : 

Benzanilid.  Exodyne. 
Antikamnia.  Phenolid. 
Antinervin. 

Resorcinol,  Resorcin. 

Resorcinol  is  obtained  from  galbanum,  a  resin,  by 
the  action  of  alkalies.  It  is  also  made  from  phenol, 
thus  belonging  to  the  phenol  group  of  derivatives  of 
coal  tar.  It  occurs  as  white  crystals  with  an  odor  re- 
sembling phenol,  and  is  soluble  in  water,  and  also  in 
alcohol.  It  is  antiseptic  and  disinfectant,  inferior, 
however,  in  these  respects  to  phenol.  It  has  consider- 
able antipyretic  action,  in  large  doses,  causing  free 
diaphoresis  with  reduction  of  the  pulse  and  tempera- 
ture. The  pulse  may,  within  an  hour,  be  slowed  by  as 
much  as  one  third  its  former  number  of  beats,  and  the 
temperature  fall  three  or  four  degrees,  to  remain  down 
for  from  two  to  four  hours,  when  it  rises  again  rapidly. 
While  rising  there  may  be  chilly  feelings,  or  a  distinct 
chill. 

Doses  which  produce  these  results,  viz.,  gr.  xxx.-lx., 
cause  also,  as  preliminary  symptoms,  dizziness,  ringing 
in  the  ears,  frontal  headache,  trembling,  and  quickened 
respirations.  With  the  breaking  out  of  perspiration 
these  disturbances  die  away.  No  fatal  case  of  poison- 
ing is  known.  In  one  case,  where  120  grains  were 
taken,  giddiness  and  a  feeling  as  of  the  pricking  of 


THE  CARBON  COMPOUNDS.  l6l 

pins  came  on  immediately.  Unconsciousness  followed, 
with  subnormal  temperature  and  thready  pulse. 

The  chief  action  of  resorcinol  is  upon  the  nerve 
centres,  and  it  has  been  shown  experimentally  that 
very  large  doses  paralyze  the  heart. 

Average  dose,  gr.  ii.-o.i25  Gm. 

It  is  used  in  an  ointment,  strength  from  5  to  30  per 
cent. 

Pheno-Resorcin.     Not  official. 

A  mixture  of  phenol  and  resorcinol,  in  the  proportion 
of  two  thirds  of  the  former  and  one  third  of  the  latter. 
It  has  antiseptic  qualities. 

Acetphenetidinum,  Acetphenetidin. 
Phenacetin. 

A  preparation  belonging  to  the  phenol  group;  a  de- 
cided antipyretic,  being  also  antiseptic,  sedative, 
and  analgesic.  After  large  doses  profuse  sweating  is 
the  first  result,  appearing  in  from  thirty  to  fifty  minutes, 
and  in  one  or  two  hours  the  temperature  begins  to  fall, 
reaching  its  lowest  point  in  about  four  hours.  The  re- 
duction is  quite  marked,  averaging  about  3°,  while  a 
fall  of  5°  or  6°  has  been  known.  Some  depression  may 
follow — not  severe  enough  usually  to  be  alarming — 
with  weak  and  chilly  feelings  and  weakened  pulse. 
The  rise  of  temperature  is  more  gradual  than  the  fall. 
In  comparison  with  the  activity  of  other  antipyretics, 
ten  grains  of  phenacetin  are  said  to  equal  fifteen  grains 
of  antipyrine  or  quinine,  and  thirty  grains  of  salicylate 
of  soda,  and  to  be  equal  in  power  with  antifebrine, 
though  less  rapid  in  action  and  more  enduring  in  its 
effect. 

An  eruption  of  the  skin  sometimes  occurs  in  anaemic 
patients. 

Phenacetin  is  almost  insoluble  in  water,  and  is  given 
dry  on  the  tongue,  or  in  compressed  tablets,  or  capsules. 

Average  dose,  gr.  v.-o.3  Gin. 


1 62  MATERIA    MEDICA    FOR  NURSES. 

Allied  to  phenacetin,  all  unofficial,  are  : 
lodophenine.        Hydracetin. 

Methacetin.         Phenocoll  Hydrochloride. 

Exalgine.    Not  official. 

A  preparation  similar  to,  and  derived  from,  acetanilid. 
It  has  analgesic  power,  and  the  name  was  given  with 
reference  to  this  quality,  and  does  not  describe  its 
chemical  constitution,  as  do  many  of  the  names  of  new 
remedies.  It  is  hypnotic  and  anodyne,  and  com- 
paratively free  from  ill  after-effects. 

Its  action  in  the  relief  of  pain  is  rapid.  In  some 
cases,  dizziness,  trembling,  weakness  of  the  knees,  and 
loss  of  muscular  power  in  the  eyelids  have  appeared 
almost  immediately  after  its  administration,  passing  oft 
in  a  short  time. 

It  is  given  dry  on  the  tongue,  in  powder  or  in  tablets. 

Average  dose,  gr.  iii.-o.2  Gm. .) 

Pyridine.    Not  official 

Pyridine  is  found  in  nature  as  one  of  the  principles 
of  tobacco-juice,  and  is  imitated  in  chemistry,  and  de- 
rived from  chinolin.  It  is  a  volatile  liquid  with  strong 
aromatic  odor.  It  gives  off,  at  ordinary  temperatures, 
a  vapor  which  is  used  medicinally,  having  a  stimulant 
effect  on  the  respirations  and  on  the  spinal  cord.  On 
the  heart  it  has  an  influence  resembling  that  of  digitalis, 
increasing  the  strength  of  the  systole. 

Average  dose,  TIJ,  v.-o.3  Gm. 

Benzosulphinidum.    Saccharin. 

Saccharin  is  a  substance  produced  by  a  very  compli- 
cated chemical  process  from  a  coal-tar  product  called 
toluene.  It  is  the  sweetest  of  known  substances,  being 
between  two  hundred  and  three  hundred  times  sweeter 
Mian  sugar,  but  in  chemical  constitution  it  is  an  acid. 


THE  CARBON  COMPOUNDS.  163 

It  Is  not  a  food,  like  sugar,  nor  a  medicine,  as  it  has 
no  specific  effect  on  the  system.  It  may  be  used  in- 
stead of  sugar  in  diseases  where  sugar  is  forbidden, 
as  diabetes. 

It  retards  digestion.     Average  dose,  gr.  iii.-o.2  Gm. 

Acidum  Oleicum. 
Oleic  Acid. 

A  fluid  fatty  acid  made  from  olein,  the  fluid  principle 
of  oils  and  fats,  by  the  action  of  heated  steam.  It  is 
used  in  the  preparation  of  medicinal  ointments  called 
oleates,  of  which  only  one  is  now  official,  viz.,  the  oleate 
of  mercury.  Other  substances  that  have  been  used  in 
oleates  are:  veratrine,  cocaine,  quinine,  atropine,  and 
zinc. 

Petrolatum  (Vaseline). 

Vaseline  is  a  semi-solid  substance  obtained  from 
petroleum  by  distillation  and  purification,  and  is  used 
alone  as  an  emollient,  and  also  as  the  basis  of  various 
ointments. 


Glycerinum,  Glycerin.    Glycerol. 

Glycerin  is  obtained  by  the  reaction  of  fats  and  fixed 
oils  with  watery  alkaline  fluids.  Chemically  it  is 
classed  with  the  alcohols.  It  is  always  set  free  in  the 
process  of  soap-making  as  a  waste  product,  and  so 
made  is  purified  and  sold,  though  the  larger  part  of  the 
glycerin  in  commerce  is  manufactured  directly  by  the 
decomposition  of  fats  by  heated  steam. 

Glycerin  absorbs  water  from  the  air  and  mixes  with 
water  in  all  proportions.  If  pure  it  cannot  become 
rancid. 

Applied  externally  it  is  unirritating  to  the  sound 
skin,  but  painful  if  there  be  any  abrasions. 


1 64  MATERIA  MEDIC  A  FOR  NURSES. 

It  is  slightly  stimulant  and  antiseptic,  and  tends  to 
make  the  skin  dry  and  brittle.  It  is  readily  absorbed 
when  applied  externally. 

Internally  it  has  no  special  effect  on  the  stomach,  but 
is  supposed  to  have  some  nutritive  power.  It  is  pro- 
duced normally  in  the  intestines  during  the  digestion 
of  oils  and  fats.  If  administered  in  free  doses  it  has  a 
laxative  action,  and  for  this  purpose  is  given  alone,  or 
in  combination  with  castor  oil. 

The  laxative  action  is  very  notable  when  glycerin  is 
administered  as  an  enema;  a  small  amount —  3  ss.-  §  ii. 
— acts  quickly  and  satisfactorily. 

Glycerin  suppositories  are  also,  in  most  instances, 
very  efficacious.  Average  dose,  3  i.~4  mils. 


Preparations. 

Glyceritum  Phenolis. 
Glycerite  of  Phenol. 

Contains  20  parts  of  phenol  to  80  of  glycerin. 

Glyceritum  Acidi  Tannici. 
Glycerite  of  Tannic  Acid. 

The  same  strength  as  the  above. 

Glyceritum  Boroglycerini. 
Glycerite  of  Boroglycerin. 

Boric  acid  3  parts  to  7  of  glycerin. 


PART  II. 

ORGANIC  MATERIA  MEDICA. 

THE  VEGETABLE  KINGDOM. 


ARRANGED  UNDER  BOTANICAI,  DIVISIONS  OR  NATURAL 
ORDERS. 


Fam.  Ranunculacea. 

Aconitum,  Aconite. 
Monkshood  (Wolfsbane). 

Aconite  is  a  tall  perennial  plant  bearing  a  spike  of 
blue  flowers;  found  native  in  Europe,  and  cultivated 
in  the  United  States.  The  official  portion  is  the  root, 
which  is  from  3  to  4  inches  long,  about  }  inch  in 
diameter  at  the  base,  and  tapers  to  a  fine  point.  It  is 
brown  in  color,  externally,  and  has  been  mistaken  for 
horse-radish,  but  the  latter  is  whitish,  does  not  taper 
gradually  but  has  almost  the  same  diameter  for  several 
inches,  and  has  a  strong  odor  when  scraped,  which 
aconite  root  has  not. 

There  are  several  varieties  of  the  plant,  all  more  or 
less  poisonous. 

Physiological  Actions. 

Aconite  applied  locally  to  the  skin  or  mucous  mem- 
brane acts  on  the  terminations  first  of  the  sensory  and 

165 


1 66  MATERIA   MEDICA   FOR  NURSES, 

next  of  the  motor  nerves,  as  a  depressant  or  sedative, 
and  causes  tingling  followed  by  numbness  and  insensi- 
bility. 

Taken  internally  aconite  is  sedative  to  the  heart 
and  respirations;  is  diuretic  and  diaphoretic,  and 
reduces  temperature.  It  has  no  effect  on  the  brain. 
Medicinal  doses,  given  close  together,  reduce  the  fre- 
quency, force,  and  tension  of  the  pulse,  produce  a 
gentle  perspiration,  and  increase  the  amount  of  urine. 
Respiration  becomes  slower  and  deeper;  the  tempera- 
ture falls.  The  tendency  of  the  pulse  under  the  in- 
fluence of  aconite  is  to  become  small,  compressible,  and 
weak. 

larger  doses,  or  a  single  full  medicinal  dose,  produce 
a  tingling  feeling,  usually  first  noticeable  in  the  lips 
or  extremities;  or,  if  the  impression  be  decided,  the 
tingling  may  be  felt  over  the  whole  body. 

There  may  be  also  a  raw,  irritable,  or  constricted 
feeling  in  the  throat,  and  difficulty  in  swallowing, 
caused  by  anaemia  of  the  throat.  There  is  muscular 
weakness;  giddiness  and  disorders  of  vision  may  be 
produced,  especially  if  any  exertion  be  made;  the  respi- 
rations are  diminished,  and  the  pulse  may  fall  to  30  or 
40  a  minute. 

The  first  effects  of  medicinal  doses  are  usually  shown 
in  half  an  hour,  and  the  symptoms  mentioned  will  pass 
off  in  three  or  four  hours.  After  poisonous  doses,  if 
large,  death  may  occur  immediately  from  instant  par- 
alysis of  the  heart- muscles;  or  the  symptoms  may  come 
on  in  a  few  moments  and  death  occur  soon  after,  the 
average  time  being  between  three  and  four  hours. 

Symptoms  of  Poisoning. 

The  first  symptom  of  poisoning  is  the  characteristic 
tingling,  which  is  diagnostic  of  every  variety  and 
preparation  of  aconite. 

The  pulse  fails  rapidly,  becoming  weak,  irregular, 
intermittent,  and  slow;  the  respirations  are  shallow, 
weak,  and  sighing,  irregular  and  slow.  There  is 


THE    VEGETABLE  KINGDOM.  167 

anaesthesia  of  the  surface  and  great  muscular  weak- 
ness; the  tongue  and  breath  are  cold;  the  skin  covered 
with  a  cold  sweat.  The  face  has  an  anxious  look  and 
is  sunken  and  livid.  The  eyes  are  glaring,  the  eye- 
balls protruding;  the  pupils  are  generally  dilated.  The 
voice  is  suppressed.  There  may  be  vomiting,  although 
it  does  not  always  occur.  The  mind  usually  remains 
clear,  but  there  are  sometimes  convulsions,  and  in  these 
cases  stupor  and  unconsciousness  may  be  present.  In 
the  latter  stages  of  collapse  the  special  senses  may  be 
lost,  especially  the  sight. 

Treatment  of  Poisoning. 

The  first  thing  necessary  is  to  empty  the  stomach 
and  wash  it  out  with  the  stomach-pump.  Hot  and 
concentrated  alcoholic  stimulants  are  given;  external 
heat  applied;  the  patient's  head  lowered  beneath  the 
line  of  his  feet  by  taking  out  the  pillows  and  elevating 
the  foot  of  the  bed;  and  absolute  quiet  and  rest  main- 
tained. Artificial  respiration  may  be  practised,  and 
cardiac  stimulants  given  hypodermically. 

Atropine  is  a  physiological  antagonist,  stimulating 
respiration,  and  ammonia  has  the  same  effect. 

Digitalis  counteracts  the  depression  of  the  heart,  but 
acts  slowly,  while  aconite  is  exceedingly  rapid  in  action. 

Precautions. 

The  pulse  should  always  be  taken  before  giving  a 
dose  of  aconite,  and  respirations  and  temperature 
watched.  Any  possibility  of  cold  air  or  draughts  must 
be  guarded  against,  the  skin  being  relaxed,  and  no  ex- 
ertion on  the  part  of  the  patient — such  as  sitting  up  in 
bed — allowed. 

Preparations  of  Aconite. 

Fluidextractum  Aconiti. 
Fluidextract  of  Aconite. 

Average  dose,  ^  ss.-o.O3  mil. 


168  MATERIA  MEDIC  A  FOR  NURSES. 

Tinctura  Aconiti. 
Tincture  of  Aconite. 

Made  from  the  root.  Strength  10%.  Average  dose, 
TTl  iii.-o.2  mil,  in  water. 

Extractum  Aconiti. 
Extract  of  Aconite. 

One  Gm.  of  the  extract  represents  about  four  Gm.  of 
aconite.    Average  dose,  gr.  f-o.oi  Gm. 
Aconitina. 
Aconitine. 

An  alkaloid  or  active  principle  obtained  from  aconite. 
Average  dose,  gr.  4^0-0.00015  Gm. 

Linimentum  Aconiti. 
Aconite  Liniment.  Not  official. 

For  external  use;  strength,  2  <f>.  St.  Jacob's  oil,  a 
quack  medicine,  contains  aconite. 

Staphisagria,  Stavesacre. 

The  dried  ripe  seeds  of  Delphinium  Staphisagria. 
They  possess  four  alkaloids,  one  of  which,  delphinine, 
is  closely  allied  to  aconitine,  resembling  it  strongly  in 
action.  It  is  even  more  depressing".  The  chief  use  of 
Staphisagria  is  as  a  parasiticide.  The  preparation  for 
this  purpose  is  called  delphine. 

Podophyllum,  May  Apple,   Mandrake. 

The  dried  rhizome '  and  rootlets  of  the  May  apple,  a 
perennial  herb  of  the  Northern  and  Middle  United 
States.  An  alkaloid,  berberine,  and  two  resins,  are 
the  active  principles. 

Physiological  Actions. 

Podophyllum  is  an  active  cathartic  with  chola- 
gogue  properties.  Its  actions  are  shown  not  only 

1  Root  stock. 


THE    VEGETABLE   KINGDOM.  169 

when  taken  internally,  but  also  when  applied  to  a 
broken  surface  or  given  hypodermically.  It  has  a 
bitter,  acrid  taste,  and  causes  slight  salivation,  irritation 
of  the  stomach,  nausea,  and  griping  pains.  In  large 
doses  it  causes  severe  colic.  The  purgative  action  is 
very  slow,  requiring  ten  hours  or  more,  and  is  due  to 
stimulation  of  the  intestinal  glands  and  of  the  muscular 
coats  of  the  intestine;  also  to  a  stimulant  action  on  the 
liver,  with  a  decided  increase  in  the  flow  of  bile. 

In  large  quantities  it  may  cause  poisoning.  Cases 
of  poisoning  in  children  have  happened,  with  vomiting, 
purging,  epileptiform  convulsions,  coma,  and  collapse. 

Preparations. 

Resina  Podophylli. 
Resin  of  Podophyllum. 

Average  dose,  as  a  laxative,  gr.  1^-0.005  Gm. 
As  a  purgative,  gr.  £-0.01  Gm. 

Fluidextractum  Podophylli. 
Fluidextract  of  Podophyllum. 

Average  dose,  TT[  viii.-o.5  mil. 

Podophyllum  used  externally  is  irritant,  and  may  in- 
flame the  eyes  if  carelessly  handled. 

Cimicifuga,  Black  Snakeroot. 

The  dried  rhizome  and  rootlets  of  Cimicifuga  race- 
mosa,  an  indigenous  plant,  containing  a  volatile  oil, 
two  resins,  and  tannin. 

Cimicifuga  has  antispasmodic  action.  In  moderate 
doses  it  has  been  used  as  a  stomachic  and  cardiac 
tonic,  and  it  increases  somewhat  the  action  of  the  skin 
and  kidneys.  In  large  doses  it  slows  the  heart,  and 
raises  blood-pressure,  acting  like  digitalis,  and  in  ex- 
cessive doses  it  produces  giddiness,  severe  headache, 
and  prostration.  No  cases  of  poisoning  are  known. 
The  preparations  should  not  be  kept  long,  as  they  spoil 
with  age. 


I/O  MATERIA  MEDIC  A  FOR  NURSES. 

Preparations. 

Fluidextractum  Cimicifugae. 
Fluidextract  of  Cimicifuga. 

Average  dose,  TTl  xv.-i  mil. 

Tinctura  Cimicifugae.    Not  official. 
Tincture  of  Cimicifuga. 

Average  dose,  3  i.-4  mils. 

Adonis  Vernalis.    Not  official. 

The  root  of  Adonis  vemalis^  contains  a  glucoside 
named  adonidin.  It  is  allied  in  action  to  digitoxin, 
one  of  the  principles  of  digitalis,  but  is  more  irritating 
to  the  digestive  organs. 

Physiological  Actions. 

Adonidin  stimulates  the  heart  and  vaso-motor 
centers  under  some  circumstances.  It  is  not  cumulative 
in  tendency.  It  has  no  special  power  as  a  diuretic, 
though  there  may  be  some  slight  action  resulting  from 
the  effect  upon  circulation  in  the  kidneys. 

In  overdoses  adonidin  produces  vomiting  and  diar- 
rhoea. 

Preparations. 

Adonidin.    Not  official. 

Average  dose,  gr.  £-0.008  Gm. 
Infusion  of  Adonis  Vernalis.    Not  official. 

Average  dose,  3  ii.-8  mils. 

Hydrastis,  Golden  Seal. 

The  roots  and  root  stocks  of  Hydrastis  canadensis 
yield  the  alkaloids  verberine,  xanthopuccine,  and  hy- 
drastine,  of  which  the  last  is  the  active  principle. 


THE    VEGETABLE  KINGDOM.  I? I 

Physiological  Actions. 

Hydrastis  is  an  astringent  bitter.  It  stimulates 
the  gastrointestinal  tract,  creates  appetite,  and  pro- 
motes the  functions  of  the  liver.  It  is  also  an  anti- 
periodic.  It  is  ecbolic,  causing  uterine  contractions. 
Applied  locally  to  mucous  membranes  it  is  tonic. 

In  poisonous  doses  it  has  caused  salivation,  vomit- 
ing, muscular  tremblings,  loss  of  voluntary  movement, 
rise  of  temperature,  feeble,  rapid  pulse,  convulsions, 
and  death  from  failure  of  the  respirations. 

Preparations. 

Tinctura  Hydrastis. 
Tincture  of  Hydrastis. 

Average  dose,  3  i.~4  mils. 

Fluidextractum  Hydrastis. 
Fluidextract  of  Hydrastis. 

Average  dose,  TH,  xxx.-2  mils. 

Hydrastininae  Hydrochloridum. 
Hydrastinine  Hydrochloride. 

A  synthetic  alkaloid  obtained  by  oxidizing  hydras- 
tine.  It  is  an  oxytocic  and  muscular  stimulant.  In 
overdoses  a  depressant  to  the  whole  motor  tract. 

Average  dose,  gr.  £-0.03  Gm. 

Fam.  Menispermacece. 

Calumba. 

The  root  of  Jateorhiza  palmata^  of  Eastern  Africa, 
contains  an  alkaloid,  berberine;  a  bitter  neutral  prin- 
ciple, colombin;  and  colombic  acid.  It  contains  no 
tannin,  and  may  be  given  with  iron. 

Calumba  is  a  bitter  tonic  and  stomachic,  stimulat- 
ing the  flow  of  saliva,  the  glands  and  blood-vessels  of 


I~2  MATER  I  A   MEDIC  A   FOR  NURSES. 

the  stomach,  and  also  the  gastric  nerves,  causing  a 
sensation  of  hunger.  Calumba,  like  bitters  in  general, 
has  some  power  to  overcome  fermentation  or  decompo- 
sition in  the  stomach  and  intestines;  promotes  peristal- 
sis (bitters  containing  tannin  have  not  this  property); 
removes  flatulence  and  tends  to  regulate  the  evacuation 
of  the  bowels. 

Bitters  if  given  in  excess  or  for  a  long  time  irritate 
the  stomach  and  bring  on  indigestion.  Calumba  is 
one  of  the  least  irritating  of  this  class  of  medicines. 

L,ike  all  bitter  stomachics  it  must  be  given  well 
diluted,  and  about  half  an  hour  before  meals. 

Tinctura  Calumbae. 
Tincture  of  Calumba. 

Strength,  20%.    Average  dose,  3  i-~4  mils. 

Fluidextractum  Calumbae.    Not  official. 
Fluidextract  of  Calumba. 

Dose,  Tit  xv.-i  mil. 

Picrotoxinum  (Picrotoxin).     Not  official. 

The  fruit  (called  fish  berries)  of  Anamirta  paniculata, 
an  Asiatic  plant,  yields  an  active  principle,  picrotoxin, 
a  bitter  neutral  substance. 

It  is  an  active  excitant  of  the  brain  and  spinal  cord; 
stimulates  secretions,  especially  of  the  intestines;  causes 
nausea  and  vomiting,  and  slows  the  heart  and  respira- 
tions. In  overdoses  it  produces  muscular  twitchings, 
stupor,  delirium,  convulsions,  and  coma;  and  may 
cause  death  by  paralysis  of  the  heart. 

The  temperature  is  slightly  raised  by  picrotoxin. 

It  has  been  used  externally  in  an  ointment,  and  con- 
vulsions and  death  have  followed  its  use  in  this  way. 


THE   VEGETABLE  KINGDOM.  1/3 

Fam.  Papaveracecs. 
Opium. 

Opium  is  the  juice  of  the  unripe  capsules  of  the 
Papaver  somniferum  or  white  poppy,  thickened  by 
evaporation  (inspissated),  and  is  obtained  by  incising 
the  capsules  with  a  small  sharp  knife,  when  the  juice 
flows  forth,  and  hardens  into  a  semi -solid  mass.  It  is 
produced  chiefly  in  Turkey,  Asia  Minor,  Persia,  and 
India. 

That  used  in  the  United  States  is  almost  all  brought 
from  Asia  Minor  and  called  Smyrna  or  Turkey  opium. 
Moist  opium  should  contain  not  less  than  9.5%  of 
morphine. 

When  dried  and  powdered,  opium  is  yellow  brown  in 
color,  and  dissolves  in  water,  alcohol,  and  dilute  acids. 

Opium  is  an  exceedingly  complex  substance,  con- 
taining the  alkaloids  morphine,  codeine,  narceine, 
narcotine,  thebaine,  papaverine,  porphyroxine,  crypto- 
pine,  meconine,  opianine,  and  paramorphine;  meconic, 
thebolactic,  and  sulphuric  acids;  fixed  oils,  odorous 
principles,  extractives,  gum,  resin,  salts,  glucose,  and 
other  unimportant  substances,  with  about  16  per  cent. 
of  water. 

Physiological  Actions. 

Opium  is  generally  considered  to  be  anodyne  and 
anaesthetic  when  applied  to  the  unbroken  skin,  yet 
some  authorities  consider  this  doubtful,  and  attribute 
any  good  effect  from  such  application  to  the  moist  heat 
or  to  the  resins  and  spirits  of  the  liquid  preparations. 
Mucous  surfaces,  wounds,  ulcers,  etc.,  readily  absorb 
opium.  The  local  action  of  the  drug  is  astringent. 
In  the  mouth  the  mucous  lining  is  dried,  the  tongue 
coated,  and  a  sensation  of  thirst  produced.  In  the 
stomach  opium  may  cause  a  short  period  of  irritation 
of  the  nerves,  with  nausea,  but  soon  sensibility  is 
diminished,  the  secretions  checked,  sensations  of  appe- 
tite and  hunger  are  lost,  the  digestive  powers  fail,  and 


1/4  MATERIA   MEDICA  FOR  NURSES. 

the  afferent  nerves  are  depressed,  so  that  the  act  of 
vomiting  is  produced  with  difficulty,  and  direct  emetics 
may  fail  altogether. 

In  the  intestines  opium  is  sedative  and  astringent. 
All  impressions  given  to  the  nerves  from  the  mucous 
membrane  are  weakened;  the  secretions  are  diminished, 
peristaltic  action  is  checked,  and  pain  relieved. 

Given  by  the  rectum,  as  in  enemata  or  suppositories, 
opium  allays  local  pain,  checks  diarrhoea,  and  acts  as 
an  antispasmodic,  keeping  the  parts  at  rest,  and  pre- 
venting irritability  of  the  mucous  membrane. 

The  secretion  of  bile  is  diminished  and  the  urine 
lessened  in  quantity.  The  bowels  are  constipated. 
The  skin  is  the  only  organ  whose  action  is  not  de- 
creased by  opium.  Perspiration,  instead  of  being 
lessened,  is  excited,  especially  by  some  preparations, 
which  are  decidedly  diaphoretic. 

Opium  is  eliminated  by  the  breath,  perspiration, 
urine,  and  milk.  This  last  is  to  be  remembered  in 
giving  opium  to  a  nursing  mother. 

The  pre-eminent  influence  of  opium  is  upon  the  brain 
as  a  stimulant,  hypnotic,  and  narcotic.  These  actions 
are  more  prominent  in  man  than  in  animals,  and  in 
highly  civilized  than  in  lower  races. 

The  stimulant  effect  is  noticeable  sometimes  after  a 
medicinal  dose,  and  precedes  the  hypnotic  action  by  a 
short  variable  period.  In  persons  who  are  accustomed 
to  large  doses  of  opium  the  period  of  stimulation  is 
more  marked.  The  nerve  centres  which  preside 
over  the  imagination  are  specially  affected.  The  im- 
aginative powers  are  heightened  and  the  will  power 
weakened. 

Opium  also  acts  upon  the  heart  as  a  stimulant,  sus- 
taining and  strengthening  it.  The  opium  pulse  re- 
sembles the  healthy  pulse,  being  strong,  moderately 
slow,  and  regular ;  full,  compressible,  and  of  moderate 
length,  and  is  not  disturbed  by  change  of  position, 
exercise,  or  mental  agitation — an  important  difference 
between  the  action  of  opium  and  other  cardiac  stimu- 
lants. 


THE    VEGETABLE  KINGDOM.  1 75 

The  anodyne  effects  of  opium  depend  chiefly  on 
morphine,  its  most  important  alkaloid.  There  are 
some  differences  of  action  between  opium  and  morphine 
alone,  as  follows:  opium  is  less  soluble  than  morphine, 
is  more  slowly  absorbed,  and  the  effects  last  longer; 
its  local  action  on  the  intestines  is  more  pronounced; 
it  reaches  the  bowels  directly  and  is  more  constipating. 
For  this  reason  it  is  preferred  in  many  cases  of  intestinal 
trouble. 

Opium  is  not  as  powerful  a  narcotic  as  morphine,  as 
several  of  its  other  alkaloids  (thebaine,  codeine,  and 
narcotine)  have  a  more  or  less  exciting  or  convulsaut 
action  which  modifies  the  whole  drug. 

Opium  disorders  the  digestion  more  than  morphine 
and  has  greater  power  as  a  diaphoretic. 

Finally,  opium,  being  of  variable  strength,  is  not  as 
reliable  as  morphine,  the  quantity  of  which  in  a  given 
dose  may  be  accurately  determined.  The  relative 
strength  of  opium  to  morphine  is  about  as  £  or  \  to  i. 

Symptoms  of  Poisoning. 

The  mildest  manifestation  of  opium  on  the  brain  is  a 
quiet,  dreamy  state,  ending  after  a  short  time  in  sleep, 
either  light  and  natural  or  heavy,  and  passing  into 
stupor,  according  to  the  size  of  the  dose.  There  is 
hyperaemia  of  the  brain  in  the  sleep  caused  by  opium. 
On  awakening  there  may  be  slight  depression  with 
headache  and  languor,  caused  by  imperfect  aeration  of 
blood — which  is  in  turn  the  result  of  diminished  respi- 
rations—  and  lasting  several  hours.  There  may  be 
nausea,  or  even  vomiting,  or  the  patient  may  return  at 
once  to  the  normal  condition.  This  is  the  first  stage 
of  opium  narcosis.  After  large  doses  the  second  stage 
comes  on  quickly,  or  at  once.  The  symptoms  of  this 
condition  are  very  like  those  of  congestion  of  the  brain. 

The  pupils  are  contracted,  the  face  flushed,  often 
cyanosed;  the  pulse  is  full,  slow,  and  strong;  the  res- 
pirations slow  and  deep,  sometimes  stertorous;  the 
skin  is  usually  dry  and  warm,  and  unconsciousness  is 
apparently  complete,  though  the  patient  can  usually 


176  MATERIA   MEDIC  A   FOR  NURSES. 

be  roused,  and  if  so,  the  breathing  becomes  more  rapid 
and  the  face  regains  its  natural  color. 

There  is  usually  retention  of  urine.  Death  does  not 
often  occur  in  this  stage  of  opium  narcosis. 

The  third  stage  is  that  of  prostration  with  profound 
coma,  from  which  it  may  be  impossible  to  rouse  the 
patient;  but,  if  he  can  be  roused  and  made  to  speak, 
his  answer,  though  it  may  not  be  complete,  will  be 
rational,  and  there  will  be  no  thickness  or  indistinct- 
ness of  articulation,  as  there  is  in  alcoholic  poisoning. 
This  is  characteristic  of  opium  poisoning.  The  respira- 
tions are  weak,  shallow,  irregular,  and  slow;  they  may 
fall  to  one  or  two  in  a  minute,  while  in  the  second  stage 
they  may  frequently  be  found  as  low  as  four  or  five. 
The  face  is  pallid  and  cyanosed;  the  skin  cold  and 
covered  with  perspiration;  the  pupils  are  absolutely 
contracted,  and  just  before  death  they  dilate  widely. 
The  pulse  becomes  more  and  more  rapid  and  weak,  and 
death  results  from  failure  of  the  respirations. 

Treatment  of  Poisoning. 

In  treating  opium  poisoning  the  stomach-pump 
should  be  employed  every  half-hour  until  the  patient 
is  out  of  danger.  Removing  contents  of  stomach  once 
is  not  sufficient,  because  any  opium  that  may  have 
been  absorbed  is  secreted  into  the  stomach  and  must 
be  removed  to  prevent  reabsorption. 

Potassium  permanganate  (3-5  gr.  in  a  glass  of  water) 
should  be  the  first  thing  given,  and  it  should  be  given 
every  half- hour,  just  after  the  stomach  is  washed  out 
with  the  stomach-pump.  Atropine,  strychnine,  and 
caffeine  may  be  used  hypodermically  as  stimulants  and 
to  counteract  the  systemic  effect  of  the  opium.  Care 
must  be  taken  that  the  patient  does  not  become  chilled 
or  exhausted.  Too  vigorous  exercise  or  physical 
stimulation  is  not  good. 

The  treatment  of  opium  poisoning  is  mainly  directed 
toward  maintaining  respiration,  and  in  those  cases 
where  symptoms  of  narcotism  arise  gradually  after  the 
giving  of  medicinal  doses,  it  is  enough  simply  to  work 


THE    VEGETABLE  KINGDOM.  I// 

toward  this  one  object,  by  rousing  the  patient  and  try- 
ing to  keep  him  roused  until  the  effects  wear  away  of 
themselves.  Naturally,  in  the  case  of  narcotism  after 
hypodermic  injections,  emetics  would  be  useless. 
Black  coffee,  as  strong  as  possible,  is  given  through  a 
tube  into  the  stomach,  if  necessary,  or  by  rectum,  as  it 
will  sometimes  be  difficult  to  make  the  patient  swallow. 

In  those  cases  where  a  large  dose  has  been  taken  by 
mouth,  the  stomach  must  be  emptied.  A  tablespoon- 
ful  of  mustard  in  a  glass  of  warm  water  may  be  given, 
and  repeated  in  ten  minutes,  and  gr.  xxx.  each  of 
ipecac  and  sulphate  of  zinc  may  be  afterwards  given 
and  repeated  once  or  twice  at  intervals  of  fifteen  min- 
utes, with  plenty  of  warm  water.  If  emetics  refuse  to 
act  on  the  torpid  stomach,  the  stomach-pump  must  be 
used,  but,  though  it  acts  better  than  emetics  when  fluid 
preparations  have  been  taken,  it  is  useless  if  the  solid 
drug  has  been  used. 

After  washing  out  the  stomach,  respiration  must  be 
supported  in  every  possible  way,  yet  measures  which 
may  exhaust  the  patient's  strength  are  to  be  avoided 
Black  coffee  is  given  as  before  mentioned.  Cold  or 
alternate  hot  and  cold  douches  may  be  applied  to  the 
head  and  chest.  Artificial  respiration  should  be  kept 
up  untiringly,  for  hours  if  necessary,  or  the  battery 
may  be  used. 

The  bladder  must  be  emptied  by  the  catheter,  to  pre- 
vent reabsorption,  and  the  temperature  kept  up  by  the 
application  of  external  heat. 

Various  cardiac  and  respiratory  stimulants  are  given 
hypodermically;  atropine  is  a  physiological  antagonist 
to  the  action  of  opium  on  respiration,  being  the  most 
active  known  respiratory  stimulant;  but  it  is  necessary 
to  regulate  the  amount  given  with  great  precision  and 
with  a  thorough  understanding  of  the  entire  physio- 
logical relation  of  one  to  the  other.  Lacking  this,  it 
would  probably  be  given  rashly,  and  atropine  poison- 
ing be  added  to  the  opium  narcosis.  For  this  reason 
the  administration  of  atropine  should  not  be  under- 
taken except  under  directions  from  a  physician. 


MATERIA   MEDIC  A  FOR  NURSES. 

There  are  usually  no  sequels  to  opium  poisoning. 
The  amount  which  may  cause  death  varies  greatly  with 
idiosyncrasy  or  the  habits  of  the  patient.  Recovery 
has  taken  place  after  55  grains  of  solid  opium  and 
again  after  6  ounces  of  laudanum  had  been  taken, 
while  4  grains  of  crude  opium  have  caused  death. 

Incidental  Effects  of  Opium. 

Idiosyncrasies  are  very  common  in  regard  to  opium, 
especially  among  delicate  nervous  women.  Severe  de- 
pression sometimes  follows  ordinary  doses,  marked 
especially  by  excessive  vomiting.  In  these  cases, 
nausea  is  not  felt  while  the  patient  is  lying  down,  but 
recommences  on  rising.  Delirium  sometimes  follows, 
or  retention  of  urine.  A  common  result,  noticed  when 
the  effects  of  a  dose  are  wearing  off,  is  an  itching, 
sometimes  general,  sometimes  confined  to  the  face  and 
especially  the  nose;  and  erythema  —  red  stains  or 
blotches — appears  on  the  face.  Children  and  old  people 
bear  opium  badly.  With  children  this  is  accounted 
for  by  the  disproportionately  large  size  of  brain;  and 
women  are  more  susceptible  to  its  action  than  men. 

In  conditions  where  there  is  severe  suffering,  much 
larger  doses  than  ordinary  can  be  safely  taken,  for  the 
power  of  the  drug  then  seems  to  be  spent  in  overcoming 
the  pain. 

Preparations  of  Opium, 
Solid  Preparations. 

Extractum  Opii. 
Extract  of  Opium. 

Two  Gm.  of  opium  in  one  of  extract  Average  dose, 
gr.  ss.-o.O3  Gm. 

Pilulae  Opii. 

Pills  of  Opium.    Not  official. 

Strength,  about  one  grain  to  one  pill. 
It  is  to  be  remembered  that  opium  pills,  if  old,  are 
dry  and  hard  to  dissolve,  and  if  given  in  succession 


THE  VEGETABLE  KINGDOM.  1/9 

may  produce  alarming  symptoms  by  accumulating  in 
the  alimentary  canal  and  dissolving  all  at  once. 


Liquid  Preparations. 

Tinctura  Opii  Camphorata. 
Camphorated  Tincture  of  Opium. 
Paregoric. 

Contains  4  Gm.  of  opium  in  1000  mils;  also  benzoic 
acid,  oil  of  anise,  and  camphor  in  the  same  proportions. 
Owing  to  the  camphor  it  is  more  constipating  than  the 
other  preparations. 

As  all  children  bear  opium  badly  and  some  are  highly 
susceptible  to  it,  there  could  be  no  graver  error  than 
for  paregoric  to  be  included  in  the  home  medicine 
chest.  It  should  never  under  any  circumstances  be 
given  to  children  without  the  exact  orders  of  a  phy- 
sician, and  nurses  should  impress  on  the  less  well 
educated  mother  the  danger  of  soothing  syrups  of  a 
proprietary  nature,  as  the  amount  of  narcotics  contained 
in  them  may  ruin  the  child's  development. 

Average  dose  for  adult,  3  i.-4  mils. 

Tinctura  Opii  Deodorati. 
Tincture  of  Deodorized  Opium. 

Contains  no  narcotine  and  none  of  the  odorous  prin- 
ciples, and  is  therefore  less  nauseating  than  laudanum. 
The  strength  is  10%.  Average  dose,  ^  viii.-o-5 
mil. 

Tinctura  Opii. 
Tincture  of  Opium. 
Laudanum. 

Strength,  10%.     Average  dose,  TT[  viii.-o.5  mil. 


I  So  MATERIA  MEDIC  A  FOR  NURSES. 

Other  Preparations  Containing  Opium. 

Pulvis  Ipecacuanhas  et  Opii. 
Powder  of  Ipecac  and  Opium. 
Dover's  Powder. 

One  hundred  Gm.  contain  ten  Gm.  each  of  ipecac 
and  powdered  opium.  An  excellent  diaphoretic, 
though  somewhat  nauseating. 

To  be  taken  at  night.  Average  dose,  gr.  viii.-o.5 
Gm. 

Tinctura  Ipecacuanhas  et  Opii.    Not  official. 
Tincture  of  Ipecac  and  Opium. 

Dover's  powder  in  a  liquid  form. 
Dose,  the  same  as  tincture  of  opium. 

Tinctura  Opii  Composita. 
Compound  Tincture  of  Opium. 
Squibb's  Diarrhoea  Mixture.    Not  official. 

Contains  tincture  of  opium,   tincture  of  capsicum, 
spirits  of  camphor,  chloroform,  and  alcohol. 
Dose,  3  i.~4  mils. 

Alkaloids  of  Opium. 
Morphina,  Morphine. 

There  has  been  a  striking  elimination  of  morphine 
preparations  from  the  official  lists  within  the  past  ten 
years,  coincident  with  the  steady  movement  of  the 
medical  profession  and  intelligent  laity  to  restrict  the 
unauthorized  purchase  of  narcotic  drugs. 

Morphine  Sulphas. 
Morphine  Sulphate. 

Average  dose,  gr.  i-o.oo8  Gm. 


THE  VEGETABLE  KINGDOM.        I  Si 

Morphinae  Hydrochloridum. 
Morphine  Hydrochloride. 
Morphine  Chloride. 

Average  dose,  gr.  £-0.008  Gm. 

Diacetylmorphina. 
Diacetylmorphine. 

An  alkaloid  prepared  from  morphine  by  acetylization. 
Average  dose,  gr.  ¥5-0.003  Gm. 

Diacetylmorphinse  Hydrochloridum. 
Diacetylmorphine  Hydrochloride. 

Average  dose,  gr.  ^0-0.003  Gm. 

Pulvis  Morphinae  Compositus.    Not  official. 
Compound  Powder  of  Morphine. 
(Tully's  Powder.) 

With  the  morphine  are  combined  camphor,  glycyr- 
rhiza,  and  calcium  carbonate. 

Tinctura  Chloroformi  et  Morphinae.     Not  official. 
Tincture  of  Chloroform  and  Morphine. 

Contains  a  small  amount  of  morphine,  with  ether, 
alcohol,  oil  of  peppermint,  liquorice,  and  syrup. 
Average  dose,  TTL  viii.-o.5  mils. 

Magendie's  Solution  of  Morphine. 

This  preparation  is  not  official;  it  contains  gr.  xvi. 
of  morphine  to  f  i.,  and  it  is  used  almost  entirely  hypo- 
dermically.  If  it  is  old,  or  exposed  to  the  air,  it  de- 
velops a  fungus  which  unfits  it  for  use.  It  is  not 
irritating  to  the  tissues. 

The  analgesic  and  narcotic  action  of  morphine  is 
quickly  manifested,  coming  on  usually  within  half  an 
hour  after  an  ordinary  dose,  sometimes  in  a  few  mo- 
ments. The  length  of  time  during  which  these  effects 
last  varies  much  with  the  condition  of  the  patient,  the 
degree  of  pain  present,  and  the  extent  of  toleration  of 


1 82  MATERIA   MEDIC  A   FOR  NURSES. 

the  drug  which  has  been  established.     The  average 
may  be  put  at  four  or  five  hours. 

Codeina,  Codeine,  Methylmorphine. 

Codeine  has  slightly  exciting  action  on  the  spinal 
cord.  Its  hypnotic  action  is  feeble  and  uncertain.  It 
is  not  constipating. 

Codeinae  Phosphas. 
Codeine  Phosphate. 

Average  dose,  gr.  £^0.03  Gm. 

Codeinae  Sulphas. 
Codeine  Sulphate. 

Average  dose,  gr.  2-0.03  Gm. 

Heroin  [Trade  Name]. 

Practically  the  same  as  diacetylmorphine.  It  Is  a 
subtle  and  dangerous  drug  of  habit-forming  qualities, 
and  is  employed  in  many  trade  or  commercial  prepa- 
rations. It  has  been  much  used  as  a  sedative,  and 
when  new  was  considered  comparatively  harmless  and 
useful. 

The  addiction  of  young  delinquents  to  it  has  brought 
it  into  notoriety,  and  parents  should  be  warned  against 
cough  syrups  which  may  possibly  contain  it.  Dose, 
gr.  air  -TO  (0.003-0.006  Gm.)  in  pill  or  powder,  or  in 
aqueous  solution  with  a  few  drops  of  dilute  acetic  acid. 

Apomorphinse  Hydrochloridum. 
Apomorphine  Hydrochloride. 

Prepared  from  morphine  by  the  action  of  hydrochloric 
acid.  An  active  and  certain  emetic,  which  acts  indi- 
rectly or  through  the  vomiting  centre  in  the  medulla. 
It  may  therefore  be  given  hypodermically  if  the  patient 
be  unable  to  swallow.  In  from  five  to  twenty  minutes 
it  causes  nausea  and  repeated  vomiting. 


THE  VEGETABLE  KINGDOM.  183 

If  taken  by  the  stomach  it  does  not  irritate,  and 
leaves  no  ill  after-effects.  Very  large  doses  cause  pros- 
tration and  paralysis  of  the  voluntary  muscles  and  de- 
pression of  the  respiratory  centre. 

Small  doses  are  expectorant,  but  it  is  not  much 
used  in  this  way. 

Average  dose,  expectorant,  gr.  ^0-0.003  Gm. 

Average  dose,  emetic,  by  mouth,  gr.  i-o-oi  Gm. 

Average  dose,  emetic,  by  hypodermic,  gr.  2*0-0.005 
Gm. 

Fam.  Crucifertz. 

Sinapis  Alba  and  Nigra.    White  and  Black 
Mustard. 

The  mixed  and  powdered  dried  ripe  seeds  of  Sinapi* 
alba  and  Brassica  nigra,  grown  in  temperate  regions. 

Black  mustard  seeds  contain  various  principles,  the 
most  important  one  being  a  volatile  oil,  oleum  sinapis, 
which  is  set  free  when  water  is  added. 

It  is  a  pale-yellow  or  colorless  fluid,  of  intensely 
pungent  and  penetrating  odor,  burning  taste,  and  a 
blistering  and  corrosive  action  on  the  skin. 

White  mustard  seeds  do  not  possess  this  volatile  oil, 
but  contain  a  rubefacient  principle  which  resembles  it, 
and  which  is  set  free  in  the  same  way  on  the  addition 
of  water. 

Physiological  Actions. 

Applied  externally,  as  in  poultices,  baths,  etc.,  mus- 
tard is  a  nerve  stimulant,  rubefacient,  and  vesicant, 
causing  redness,  heat,  and  severe  burning  pain,  and, 
if  long  applied,  blistering.  Relief  of  previous  pain  and 
loss  of  sensibility  to  other  impressions  follow  the  action 
of  mustard.  The  heart,  blood-pressure,  respirations, 
and  nerve  centres  generally  are  first  stimulated,  then 
quieted,  and,  if  vesication  has  resulted,  depressed,  even 
seriously.  In  baths,  mustard  dilates  the  vessels  of 
the  skin  and  relieves  the  blood-pressure  in  congested 
organs. 


1 84  MATERIA   ME  DIG  A   FOR  NURSES. 

The  principles  of  counter-irritation  are,  first:  that, 
by  causing  dilatation  of  the  vessels  of  that  part  to 
which  application  is  made,  there  is  contraction  of  the 
vessels  in  other  parts  of  the  body,  especially  if  there  is 
nervous  connection  between  the  two,  and  following  this 
principle,  counter-irritants  are  usually  applied  at  some 
distance  from  the  congested  part,  as  in  the  use  of  foot- 
baths; second,  that,  by  increasing  the  activity  of  the 
circulation,  counter-irritants  promote  the  reabsorption 
of  inflammatory  products,  and  for  this  purpose  they  are 
sometimes  applied  directly  over  the  affected  region. 

In  making  mustard  paste,  the  addition  of  the  white 
of  an  egg  modifies  the  local  irritant  action,  making  it 
more  easily  borne  by  the  skin,  and  less  liable  to  injure 
its  structure,  while  it  does  not  interfere  with  the  phy- 
siological effect.  The  paste  should  be  mixed  only  with 
tepid  water,  as  hot  water  dissipates  the  volatile  oil, 
vinegar  destroys  it,  and  alcohol  prevents  its  formation. 
Internally,  mustard  in  small  amount,  as  taken  with 
food,  stimulates  the  appetite  and  gastric  circulation. 
In  large  doses  it  is  a  rapidly  acting  stimulant  emetic, 
leaving  little  or  no  depression. 

The  action  of  mustard  externally  must  always  be 
specially  watched  with  comatose  patients,  as  injury  to 
the  skin  does  not  show  at  first  in  a  state  of  sluggish 
circulation,  and  may  become  serious  before  it  is  noticed. 
There  is  an  official  mustard  plaster,  Emplastrum 
Sinapis,  which  is  to  be  moistened  thoroughly  with 
tepid  water  before  applying.  It  reddens  the  skin 
within  five  minutes. 

Average  emetic  dose,  3  iiss.-io  Gm. 

Fam.  Polygalacea. 
Senega,  Snake-Root. 

The  dried  root  of  Polygala  senega,  of  the  Middle  and 
Southern  United  States.  The  active  principle  is  sa- 
ponin,  a  glucoside,  allied  to  digitonin,  one  of  the  active 
principles  of  digitalis. 


THE  VEGETABLE  KINGDOM.       185 

Senega  acts  upon  the  bronchial  mucous  membrane 
as  a  stimulant  expectorant  and  also  stimulates  the 
skin  and  kidneys,  increasing  the  amount  of  urine  and 
its  solid  constituents.  It  is  not  readily  absorbed  by  the 
stomach.  Small  doses  impair  digestion,  and  large  ones 
irritate  the  stomach  and  intestines,  causing  nausea, 
vomiting,  and  diarrhoea. 

Preparations  of  Senega. 

Fluidextractum  Senegas. 
Fluidextract  of  Senega. 

Average  dose,  TTI  xv.-i  mil. 

Syrupus  Senegae. 
Syrup  of  Senega. 

Average  dose,  3  i.~4  mils. 

Fam.  Sapindacece. 
Guarana. 

The  seeds  of  Paullinia  Cupana.  They  contain  an 
active  principle,  guaranine,  which  is  similar  to  cafleine 

Fluidextractum  Guaranae. 
Fluidextract  of  Guarana. 

Average  dose,  1U  xxx.-2  mils. 

Fam.  Erythroxylacece. 
Coca. 

The  coca  tree  Erythroxylon  coca  is  cultivated  in 
South  America.  The  dried  leaves  have  a  bitter,  aro- 
matic taste,  and  an  odor  like  tea.  They  are  extensively 
used  by  the  natives,  who  chew  them  as  a  stimulant 
during  hard  labor,  scarcity  of  food,  etc.  They  contain 
an  alkaloid,  cocaine,  the  active  principle. 

Coca  in  small  doses  is  stimulant,  tonic,  and  re- 
storative. It  strengthens  the  heart  and  respirations, 


1 86  MATERIA   MEDIC  A  FOR  NURSES. 

raises  arterial  tension,  increases  the  supply  of  blood  to 
the  brain,  producing  wakefulness,  and  lessens  the  sen- 
sations of  hunger  and  fatigue.  It  has  diuretic  action, 
and  decreases  the  amount  of  urea  by  checking  tissue 
waste.  Under  the  influence  of  coca,  or  cocaine,  the 
skin  is  flushed,  the  circulation  excited,  and  a  sense  of 
heat  and  perspiration  result. 

Cocaine  in  solution  has  decided  action  as  a  local 
anaesthetic.  If  applied  to  a  mucous  surface,  as  the 
tongue  or  conjunctiva,  or  if  given  hypodermically,  it 
quickly  paralyzes  the  sensory  nerves  and  contracts  the 
small  vessels,  producing  a  state  of  local  anaemia  and 
anaesthesia,  which  lasts  for  fifteen  minutes,  or  longer, 
in  proportion  to  the  strength  of  the  application.  It  is 
often  used  in  this  way  for  minor  surgical  operations 
(amputation  of  a  finger;  opening  of  an  abscess,  etc.). 
Applied  to  the  eye  it  causes  dilatation  of  the  pupil, 
which  begins  in  a  few  minutes,  reaches  its  height  in 
about  an  hour,  and  returns  to  the  normal  state  in 
twenty-four  hours. 

Symptoms  of  Poisoning. 

Overdoses  weaken  the  heart  and  the  pulse  becomes 
small,  rapid,  and  intermittent.  There  is  a  feeling  of 
tightness  about  the  chest;  the  respirations  are  slow  and 
shallow,  and  the  skin  cold  and  clammy.  There  are 
sometimes  hallucinations  and  delirium.  Poisonous 
doses  paralyze  the  sensory  nerves  and  the  respiratory 
centre.  This  has  been  shown  by  experiments  on  ani- 
mals, no  fatal  cases  in  man  being  known. 

Five  grains  taken  by  mouth  have  caused  alarming 
symptoms:  loss  of  sight,  nausea,  incoherent  speech, 
cyanosis,  rapid  intermittent  pulse,  and  a  feeling  of 
suffocation.  In  treating  severe  depression  from  the 
use  of  cocaine,  alcohol,  opium,  and  nitrite  of  amyl  are 
used  as  antagonists. 

The  habit  of  constantly  taking  large  doses  of  cocaine 
is  readily  formed,  and  produces  emaciation,  insomnia, 
and  disordered  digestion.  If  carried  to  excess  the  in- 


THE    VEGETABLE  KINGDOM.  l8/ 

tellect  is  weakened,  even  to  insanity.  The  victim  has 
an  uncertain  gait,  an  apathetic  air,  eyes  sunken  and 
surrounded  with  a  deep  purple  ring,  trembling  lips, 
teeth  crusted  with  a  greenish  deposit,  a  peculiar  black- 
ness around  the  corners  of  the  mouth,  and  excessive 
fetor  of  the  breath.  Ascites  sometimes  appears,  and 
death  may  result  from  a  general  wasting  of  the  vital 
powers. 

Coca  is  used  as  an  ingredient  in  many  "  soft "  drinks, 
as  appears  evident  in  their  names.  This  constitutes  an 
insidious  danger  to  the  young,  in  promoting  a  craving 
for  the  drug  effects,  a  danger  which  has  been  empha- 
sized by  reliable  writers. 

Coca  must  not  be  confused  with  cocoa,  the  useful 
beverage  made  from  the  seeds  of  Theobroma  Cacao,  the 
chocolate  tree;  however,  the  chocolate,  tea,  and  coffee 
plants  are  related  to  one  another  and  also  to  the  Coca 
plant  and  the  Kola  plant,  as  well  as  to  several  others 
containing  similarly  stimulating  principles.  From 
cocaine,  the  active  alkaloid  of  coca,  is  made  the  only 
official  preparation  of  this  drug: 

Cocatnae  Hydrochloridum. 
Cocaine  Hydrochloride. 
Cocaine  Chloride. 

The  average  dose  is  gr.  £-0.015  Gm. 

Fam.  Linacea. 
Linum,  Linseed.    Flaxseed. 

The  dried  ripe  seeds  of  the  flax.  They  contain  a 
fixed  oil  and  a  quantity  of  mucilage.  The  whole  seeds 
are  used  to  make  a  demulcent  drink,  flaxseed  tea; 
ground  into  meal,  they  are  used  for  poultices;  and  the 
oil,  mixed  with  equal  parts  of  lime-water,  is  called 
Carron  oil,  and  is  used  as  a  dressing  for  burns. 

Flaxseed  Tea. 
Pour  one  quart  of  boiling  water  over  four  ounces  of 


1 88  MATERIA   ME D2C A   FOR  NURSES. 

flaxseed  (whole).  Let  it  boil  for  half  an  hour,  and 
afterwards  stand  near  the  fire  for  fifteen  or  twenty 
minutes.  Strain  and  sweeten  it,  and  flavor  with  lemon- 
juice. 


Flaxseed  Poultice. 

A  flaxseed  poultice  must  be  made  over  a  fire,  or  alco- 
hol lamp.  The  water  must  be  boiling  actively  when 
the  meal  is  added,  and  must  continue  to  boil  until  the 
poultice  is  done.  Flaxseed  bubbles  and  seethes  at  a 
point  of  heat  below  the  boiling  point  of  water,  and  is 
thus  deceptive  if  it  is  added  to  the  water  in  the  first 
place.  It  must  be  sprinkled  in  with  the  left  hand  and 
stirred  constantly  with  the  right.  If  added  in  handfuls 
the  poultice  will  be  lumpy.  When  it  has  reached  a 
proper  consistency,  not  thick  enough  to  be  stiff,  nor 
thin  enough  to  run,  it  must  be  taken  off  the  fire  and 
thoroughly  beaten  for  several  minutes.  This  makes  it 
light  and  spongy.  A  perfect  poultice  will  leave  the 
spoon  and  vessel  clean,  and  reaches  this  point  by  being 
sufficiently  boiled. 

Flaxseed  poultices  are  sedative.  They  relieve  pain 
and  relax  spasm.  In  the  early  stages  of  an  inflamma- 
tion they  draw  the  blood  to  the  surface  and  relieve 
congestion.  Resolution  may  thus  be  brought  about 
and  the  formation  of  pus  avoided. 

If  suppuration  has  begun,  the  action  of  poultices 
favors  the  process.  It  is,  therefore,  not  considered 
well  to  use  them  in  the  later  stages  of  an  acute  inflam- 
mation, as  is  often  seen  done  in  the  home  treatment  of 
abscesses,  etc.  Such  cases  should  be  brought  to  a 
physician  for  proper  treatment,  and  this  is  the  more 
important  if  the  inflammation  is  near  a  joint. 

Poultices,  if  kept  up  too  long,  give  the  tissues  a 
flabby,  water-soaked  appearance;  make  granulations 
pale,  flabby,  and  unhealthy;  depress  the  circulation 
and  the  vaso-motor  system,  and  may  impair  seriously 
the  vitality  of  the  part. 


THE  VEGETABLE  KINGDOM.  189 

Fam.  Malvacea. 

Gossypium  Purificatum,  Purified  Cotton. 
Absorbent  Cotton. 

Cotton-wool  is  too  familiar  to  need  description,  and 
is  introduced  here  as  the  first  step  in  making  collodion. 

Pyroxylinum,  Pyroxylin.    Soluble  Gun  Cotton. 

Made  by  treating  cotton-wool  with  sulphuric  and 
nitric  acids.  It  is  explosive,  and  is  soluble  in  a  mix- 
ture of  ether  and  alcohol. 

Collodium,  Collodion. 

Made  by  dissolving  pyroxylin  in  a  mixture  of  ether 
and  alcohol.  When  applied  to  the  skin,  after  evapo- 
ration of  the  ether  and  alcohol,  a  colorless,  transparent, 
contractile  film  is  deposited,  impervious  to  air  and  mois- 
ture. The  vapor  of  collodion  is  inflammable.  It  should 
be  kept  in  a  cool  place. 

Collodium  Flexile. 
Flexible  Collodion. 

Contains  camphor  and  a  small  proportion  of  castor 
oil.  The  oil  renders  the  film  pliable,  and  prevents  its 
contraction. 

Collodium  Cantharidatum. 
Cantharidal  Collodion. 
Vesicating  Collodion. 

Collodion  containing  a  solution  of  cantharides,  and 
used  as  a  vesicant.  The  skin  must  be  washed  with 
the  same  precautions  used  in  applying  cantharides,  and 
from  three  to  five  coats  painted  on  with  a  brush,  let- 
ting each  dry  separately.  The  action  of  the  vesicating 
collodion  is  hastened  by  spraying  with  ether  after 
application. 

Cantharidal  collodion  must  be  kept  in  a  cool  place 
and  must  not  be  brought  near  to  a  fire  or  flame,  as  it  is 
highly  inflammable. 


I QO  MATERIA   MEDIC  A   FOR  NURSES. 

Fam.  Sterculiacets. 

Oleum  Theobromatis,  Oil  of  Theobroma. 
Cacao  Butter. 

An  oil  expressed  from  the  seeds  of  Theobroma  Cacao, 
the  chocolate  tree.  It  has  the  consistency  of  tallow, 
and  melts  at  the  temperature  of  the  body.  It  does  not 
become  rancid,  and  is  used  as  an  unguent  and  in  the 
preparation  of  suppositories. 

Fam.  Rutacea. 
Buchu. 

The  leaves  of  Barosma  betulina  and  other  species 
of  the  same  family,  from  Southern  Africa.  They  con- 
tain volatile  oil  and  a  bitter  extract. 

Buchu  is  slightly  tonic,  owing  to  its  bitter  principle. 
It  is  also  a  stimulating  diuretic,  and  has  some 
alterative  power. 

Fluidextractum  Buchu. 
Fluidextract  of  Buchu. 

Average  dose,  Hi  xxx.,  well  diluted.     2  mils. 
Ruta  (Rue).    Not  official. 

The  leaves  of  Ruta  graveolens,  or  garden  rue.  The 
active  principle  is  a  volatile  oil,  of  hot  and  bitter  taste. 
Rue  is  a  carminative  and  emmenagogue.  In  large 
doses  it  is  irritant  and  will  cause  abortion.  It  is  less 
powerful  than  savine. 

Dose  of  the  oil,  Oleum  Rutae,  TTJ,  1.-O.O5  mil. 

Pilocarpus,  Jaborandi. 

Jaborandi,  if  applied  to  the  conjunctiva,  causes  con- 
traction of  the  pupil,  with  disturbances  of  vision.  The 


THE  VEGETABLE  KINGDOM.       igi 

effect  is  shown  in  about  ten  minutes,  and  in  an  hour 
or  two  after  begins  to  pass  off,  disappearing  entirely 
within  twenty-four  hours.  Filocarpine,  or  the  prepa- 
rations of  jaborandi,  enter  the  blood  rapidly,  and 
pass  into  the  tissues.  The  most  prominent  action  of 
the  drug  is  that  of  a  prompt  and  powerful  diaphoretic 
and  sialogogue.  It  is  also  a  cardiac  and  motor 
depressant. 

When  60  to  90  grains  of  the  infusion  of  jaborandi  are 
given  to  an  adult,  after  about  ten  minutes  the  face  and 
neck  are  flushed,  and  salivation  and  perspiration  set 
in.  These  symptoms  may  appear  in  five  or  six  minutes 
after  a  hypodermic  injection  of  the  alkaloid. 

Perspiration  begins  on  the  face,  and  extends  down- 
ward, lasts  from  three  to  five  hours,  and  is  profuse  in 
the  extreme,  amounting  to  §  ix.-xv.,  and  becomes 
alkaline  in  reaction,  if  it  is  not  so  at  first.  The  flow  of 
saliva  may  equal  5  x.-xxv.  It  is  sometimes  the  case 
that  with  profusion  of  one  secretion  there  will  be 
scantiness  of  the  other.  The  secretions  of  the  eyes 
and  nose  are  stimulated.  Sometimes  nausea  and 
vomiting  are  caused.  The  pulse  is  at  first  stimulated 
and  quickened,  but  as  diaphoresis  goes  on  it  becomes 
slow  and  weak.  The  respirations  are  lowered,  and 
apncea  may  result  from  an  increase  in  the  mucus  of  the 
bronchial  tubes.  The  temperature  falls  from  i°  to  4°, 
and  a  depressed  condition  results,  with  pallor,  chilli- 
ness, and  general  weakness,  lasting  several  hours. 

The  pupils  are  contracted,  and  vision  impaired. 

Jaborandi,  in  small  doses,  is  diuretic,  and  increases 
the  elimination  of  urea. 

The  patient  undergoing  the  diaphoretic  action  of 
jaborandi  should  be  placed  between  blankets,  and  the 
depression  is  to  be  combated  by  external  heat,  which 
also  assists  the  diaphoretic  action  of  the  drug. 

Within  three  to  six  hours  the  effects  have  passed 
away. 

(Bdema  of  the  lungs  is  the  untoward  effect  most  to 
be  dreaded  in  giving  pilocarpine.  A  person  literally 
drowns  himself  with  his  own  sweat  at  times. 


192  MATEKIA   MED1CA  FOR  NURSES. 

Preparations. 

Fluidextractum  Pilocarpi. 
Fluidextract  of  Pilocarpus. 

More  certain  in  action,  less  nauseating  and  disagree- 
able to  take  than  the  infusion  of  jaborandi,  which  was 
formerly  used.  Average  dose  TH,  xxx.-2  mils. 

Pilocarpinae  Hydrochloridura. 
Pilocarpine  Hydrochloride. 

Average  dose  by  mouth:  gr.  |-o.oi  Gm. 
Average  dose  by  hypodermic:  gr.  1*2-0.005  Gm. 

Fam.  Simarubacea. 


Quassia. 

The  wood  ofPicrasma  excelsa^  a  tree  of  Jamaica. 

The  active  principle,  quassin,  is  an  intensely  bitter 
neutral  substance. 

Quassia  is  one  of  the  most  active  of  simple  bitters 
and  stomachics.  It  contains  no  tannin,  and  is  there- 
fore not  incompatible  with  iron. 

An  infusion  of  quassia  used  as  an  enema  is  anthel- 
mintic. 

Preparations. 

Tinctura  Quassias. 
Tincture  of  Quassia. 

Strength,  20%.  Average  dose,  TTJ,  xxx.-2  mils.  An 
infusion  of  quassia  is  considered  effective  and  not  harm- 
ful to  the  patient  in  treatment  for  thread  worms.  It  is 
preceded  by  a  soap  and  water  enema,  and  is  then  given 
high  and  retained  for  some  minutes. 


THE  VEGETABLE  KINGDOM.  193 

Fam.  Rhamnacea. 

Cascara  Sagrada. 
(Sacred  Bark.) 

The  bark  of  Rhamnus  purshiana. 

Cascara  in  small  doses  is  tonic  and  stomachic ;  in 
large  dose,  laxative  or  cathartic,  with  active  and 
certain  effect.  It  sometimes  causes  griping  pain. 

Fluidextracturn  Cascarae  Sagradae. 
Fluidextract  of  Cascara  Sagrada. 

May  be  given  at  night,  or  one  or  two  hours  after 
meals.  Average  dose,  at  night,  3  ss.;  after  meals, 
ill  xv. -i  mil,  well  diluted.  The  aromatic  fluidextract 
may  be  given  in  twice  as  large  a  dose. 

Cascara  is  now  used  in  greater  quantity  than  any 
other  drug  in  the  pharmacopoeia.  It  is  pleasantly  lax- 
ative and  may  be  used  year  in  and  year  out  without 
losing  its  specific  effect,  and  without  fear  of  harm  to  the 
individual.  Usually  ten  to  twenty  drops  at  night  in  a 
little  water  is  the  best  manner  of  taking  it,  but  the 
pellet  form  is  more  convenient. 

Fam.  Burseraeea. 
Myrrha,  Myrrh. 

A  gum  resin  which  exudes  from  the  stem  of  a  species 
of  balsam.  Tincture  of  myrrh,  like  other  oleo-resins, 
is  mildly  stimulant  and  disinfectant,  and  is  useful  in 
making  mouth  washes  for  the  sick. 

It  has  some  action  as  a  stomachic,  and  in  certain 
cases  aids  the  action  of  purgatives.  It  is  also  a  uterine 
stimulant  and  emmenagogue. 

Fam.  Leguminoses. 
Tragacantha,  Tragacanth. 

A  gum  resin  which  exudes  from  the  stem  of  Astra- 
galus gummifera;  used  to  make  a  demulcent  drink. 
sa 


194  MATERIA  MEDICA  FOR  NURSES. 

Scoparius  (Broom-Tops). 

The  fresh  and  dried  tops  of  Cystisus  Scoparius,  of 
Europe  and  the  United  States.  They  contain  two 
active  principles,  scoparine  and  sparteine.  Scoparius 
is  an  excellent  diuretic.  Its  alkaloid  only  official. 

Dose  of  the  infusion,  |  i. 

Sparteinse  Sulphas. 
Sparteine  Sulphate. 

A  liquid  alkaloid  obtained  from  scoparius.  It  is 
colorless,  with  bitter  taste,  and  with  sulphuric  acid 
forms  a  crystalline  salt,  which  is  soluble  in  water. 

Physiological  Actions. 

Sparteine  is  slightly  hypnotic,  but  is  more  impor- 
tant as  a  cardiac  stimulant,  increasing  the  force  and 
regularity  of  the  pulse.  It  acts  very  quickly,  its  influ- 
ence over  a  weak,  failing  heart  being  shown  within 
half  an  hour  to  one  hour,  but  it  does  not  last  long, 
wearing  off  in  four  or  five  hours. 

It  is  not  considered  equal  to  digitalis,  but  it  is  often 
given  with  it  and  with  other  more  enduring  but  slowly 
acting  stimulants.  It  is  not  accumulative,  and  does 
not  disturb  digestion  nor  impair  the  appetite. 

It  has  not  the  diuretic  action  of  scoparius.  In  larger 
doses  it  is  a  depressant  to  the  brain  and  spinal  cord, 
and  causes  death  by  paralysis  of  the  respiratory  centre. 
Doses  of  four  to  six  grains  produce  vertigo,  headache, 
palpitations,  and  a  feeling  of  formication  in  the 
extremities;  and  large  doses  have  caused  loss  of  power 
in  the  legs,  sensations  of  heat,  with  flushed  face  and 
severe  pain  about  the  heart,  the  symptoms  beginning 
in  about  twenty  minutes  and  reaching  their  climax  in 
lour  or  five  hours. 

Average  dose,  gr.  |-o.oi  Gm. 

Copaiba. 

The  oleo-resin  of  a  species  of  Brazilian  tree.  It  is 
stimulating  to  mucous  membranes,  as  those  of  the 


THE    VEGETABLE  KINGDOM.  195 

bronchi  and  alimentary  canal.  It  is  also  a  stimulant 
diuretic  of  somewhat  irritating  character.  It  is  stated 
that  its  use  has  been  followed  in  some  instances  by 
strangury  and  in  others  by  suppression  of  urine. 

Average  dose,  TTt,  xv.-i  mil,  on  sugar,  or  made  into 
an  emulsion  with  syrup  and  gum  arabic. 

Glycyrrhiza,  Licorice  Root. 

The  root  of  Glycyrrhiza  glabra,  typica,  or  glanduli- 
fera. 

licorice  is  demulcent.  It  contains  grape-sugar, 
starch,  resin,  and  a  glucoside  named  glycyrrhizin. 

Pulvis  Glycyrrhizae  Compositus. 
Compound  Licorice  Powder. 

A  laxative  preparation  containing  senna,  licorice- 
root,  fennel,  sugar,  and  sulphur.  Its  action  resembles 
that  of  castor  oil.  It  is  not  a  hydra gogue  cathartic, 
and  given  in  moderate  doses  causes  no  griping,  and 
acts  gently — in  the  morning  if  given  at  night;  in  from 
three  to  six  hours  if  given  early  on  an  empty  stomach. 
Many  patients  find  it  nauseous;  it  is  therefore  best  to 
make  the  dose  small  as  possible  by  diluting  it  only  a 
little  and  giving  afterwards  a  larger  quantity  of  water. 

Average  dose,  3  i.~4  Gm. 

Balsamum  Peruvianum,  Balsam  of  Peru. 

A  balsam  exuded  from  the  trunk  of  Toluifera 
Pereira.  It  is  a  reddish-brown  or  nearly  black  liquid, 
thick  and  syrupy,  and  insoluble  in  water.  It  contains 
benzoic  acid,  a  number  of  resinous  principles,  a  volatile 
oil,  and  other  constituents. 

It  is  a  vascular  stimulant  and  nerve  sedative, 
antiseptic,  and  disinfectant,  and  is  used  externally 
as  an  application  to  stimulate  granulating  surfaces.  It 
is  not  used  internally,  though  it  has  mild  action  as  a 
carminative  and  as  a  stimulant  and  disinfectant 
expectorant. 


196  MATERIA  MEDICA  FOR  NURSES. 

Balsamum  Tolutanum,  Balsam  of  Tolu. 

Balsam  of  tolu  is  obtained  from  the  trunk  of  Tolui- 
fera  Balsamum.  It  is  a  reddish-yellow,  soft,  sticky 
substance  of  fragrant  odor,  soluble  in  alcohol.  It 
yields  benzoic  and  cinnamic  acids,  various  resins,  etc. 
Its  properties  are  the  same  as  those  of  balsam  of  Peru; 
but  it  is  only  used  internally  as  an  ingredient  of  cough 
mixtures. 

Physostigma  Calabar  Bean. 

The  dried  seeds  of  Physostigma  venenosum,  an 
African  plant.  They  contain  two  alkaloids:  cala- 
barine,  the  less  important  one;  and  physostigmine,  or 
eserine,  the  active  principle. 

Physiological  Actions. 

Applied  to  the  eye,  physostigmine  is  absorbed  by  the 
conjunctiva,  and  causes  contraction  of  the  pupil,  with 
slight  twitching  of  the  eyelids,  dimness  of  vision,  and 
pain  over  the  eyes. 

Calabar  bean  acts  as  a  depressant  on  the  medulla  and 
spinal  cord,  but  does  not  affect  the  cerebrum,  the  mind 
remaining  clear  in  cases  of  poisoning.  In  moderate 
doses  it  sometimes  produces  nausea,  colic,  and  in- 
creased peristaltic  motion,  resulting  in  diarrhoea. 

The  heart  is  first  stimulated,  and  then  weakened, 
and  the  same  contraction  of  the  pupil  takes  place  after 
its  internal  use. 

Symptoms  of  Poisoning* 

The  first  symptoms  of  poisoning  are:  giddiness, 
weak  pulse,  muscular  feebleness,  vomiting,  and  free 
purging.  The  respirations  become  slow  and  irregular, 
and  death  results  from  paralysis  of  the  respiratory 
centre. 

The  poison  is  treated  by  emptying  the  stomach, 
applying  external  heat,  and  using  artificial  respiration. 


THE    VEGETABLE  KINGDOM.  197 

Atropine  is  a  physiological  antagonist,  and  is  given  in 
doses  not  larger  than  gr.  -J$. 

Recovery   has   taken    place,  by   means  of  prompt 
emesis,  after  a  dose  of  gr.  xii. 

Preparations. 

Extractum  Physostigmatis. 
Extract  of  Physostigma. 

Average  dose,  gr.  |-o.oo8  Gm. 

Tinctura  Physostigmatis. 
Tincture  of  Physostigma. 

Average  dose,  ill  xv.-i  mil. 

Physostigminse  Salicylas. 
Physostigmine  Salicylate. 


Average  dose,  gr.  TT-O-OOI  Gm. 

Tamarindus,  Tamarind. 

The  preserved  pulp  of  the  fruit  of  Tamarindus 
indica.  Tamarinds  are  laxative,  and  are  taken  like 
preserves,  or  made  into  confections  with  senna. 

Senna. 

The  dried  leaflets  of  two  varieties  of  Cassia,  from 
Africa  and  Arabia.  The  active  principle  is  cathartic 
acid,  and  there  are  other  unimportant  principles. 

Senna  is  a  simple  cathartic,  and  acts  as  a  stimulant 
to  the  muscular  coat  of  the  intestines,  producing  local 
reflex  action,  active  peristalsis,  and  free  evacuations 
within  four  or  five  hours.  It  acts  especially  on  the 
colon,  and  does  not  cause  constipation  after  its  action 
is  over.  Griping  pains  are  caused  by  full  doses,  but  it 
is  usually  given  in  combination  for  the  purpose  of 
avoiding  this. 


198  MATERIA   MED  1C  A   FOR  NURSES. 

Senna  is  excreted  by  the  kidneys  and  the  mammary 
glands.  Nursing  infants  in  this  way  feel  its  action  as 
a  laxative. 

Senna  is  especially  valuable  as  a  laxative  for  child- 
ren and  may  be  given  in  the  form  of  senna  tea  made 
with  a  teaspoouful  of  the  senna  leaves  over  which  a 
teacupful  of  boiling  water  is  poured  and  allowed  to 
stand  a  short  while. 

Preparations. 

Fluidextractum  Sennae. 
Fluidextract  of  Senna. 

Average  dose,  xxx.-2  mils. 

Confectio  Sennae. 

(Tamar-Indien.) 

(Tropical  Fruit  Laxative.)    Not  official. 

This  preparation  tends  to  disorder  the  digestion. 
Dose,  3  i.~4  Gm. 

Infusum  Sennas  Compositura. 

Contains  six  per  cent,  of  senna  with  manna  and  sul- 
phate of  magnesium,  and  is  an  active  hydragogue  pur- 
gative. Dose,  §  iv.  (120  mils.) 

Syrupus  Sennae. 
Syrup  of  Senna. 

Average  dose  3  i.~4  mils. 

Fam.  Rosacea. 

Amygdala  Amara,  Bitter  Almond. 

The  ripe  seeds  of  Prunus  amygdalus,  the  bittei 
almond  tree.  The  important  principle  of  the  bitter 
almond  is  a  volatile  oil,  which  contains  from  4  to  8  % 
of  hydrocyanic  acid,  and  is  highly  poisonous. 

The  artificial  oil  of  bitter  almonds,  nitro-benzene, 
or  nitro-benzol,  is  poisonous,  and  has  caused  death. 


THE    VEGETABLE  KINGDOM.  199 

Rubus  (Blackberry). 

The  bark  of  the  root  of  Rubus  villosus  and  other 
varieties  of  rubus.  An  astringent,  containing  10  %  of 
tannin. 

Dose  ot  the  fluid  extract,  TT[  x.-3  i.;  of  the  syrup, 

31.-SL 

Prunus  Virginiana,  Wild  Cherry. 

The  bark  obtained  from  Prunus  serotina,  or  wild 
cherry  tree,  contains  tannic  acid,  a  bitter  extractive, 
amygdalin,  and  emulsin,  and  these  two  latter  princi- 
ples, when  brought  into  contact  in  watery  solution, 
produce  hydrocyanic  acid. 

The  effect  of  cherry  bark,  as  administered,  is  due  to 
the  tannic  and  hydrocyanic  acids  and  the  bitter  ex- 
tractive. None  of  these,  however,  are  present  in 
sufficient  amount  to  make  a  strong  impression,  and  the 
only  physiological  action  is  that  of  a  mild  astringent 
and  tonic.  The  syrup  of  wild  cherry  bark  is  much 
used  as  the  basis  of  cough  mixtures.  Its  average  dose 
is  gr.  xxx. -2  Gm. 

Fam.  Myrtacece. 
Eucalyptus,  Blue  Gum  Leaves. 

The  blue  gum  tree,  Eucalyptus  Globulus,  is  found  in 
southern  countries.  From  a  hygienic  point  of  view  it 
is  unusually  interesting.  It  has  an  enormous  capacity 
for  absorbing  water  from  the  soil.  One  tree,  it  is  said, 
will  absorb  in  twenty-four  hours  ten  times  its  weight 
of  water.  Swamps  are  therefore  drained  and  trans- 
formed into  dry  land  by  planting  the  eucalyptus.  It 
is  also  believed  that  it  purifies  the  air  of  malarial  dis- 
tricts by  absorbing  poisonous  emanations  and  by  giving 
forth  balsamic  principles. 

It  is  largely  cultivated  in  southern  malarial  locali- 
ties; for  instance,  in  the  Roman  Campagna,  portions 
of  which  it  has  transformed  into  habitable  regions. 


200  MATERIA   MEDICA   FOR  NURSES. 

The  leaves  only  are  official.  They  yield  tannic  acid, 
the  principles  turpene,  cymol,  eucalyptol,  and  others. 

Physiological  Actions. 

It  is  tonic  to  appetite  and  digestion,  and  stimulates 
all  the  juices  of  the  alimentary  tract.  It  is  destructive 
to  low  forms  of  life,  antimalarial,  diaphoretic,  and 
a  stimulant  expectorant.  It  is  eliminated  by  the 
skin,  mucous  membranes,  and  kidneys.  It  is  given 
when  quinine  cannot  be  administered,  its  effect  being 
much  the  same.  In  excessive  doses,  symptoms  similar 
to  those  caused  by  overdosing  with  quinine  appear,  as 
headache,  palpitations,  and  numbness  of  the  limbs. 

Preparations. 

Oleum  Eucalypti. 
Oil  of  Eucalyptus. 

The  essential  oil,  which  is  the  active  principle  of  the 

drug.     Average  dose,  fit  viii.-o.5  mil,  in  emulsion  or 
capsule. 

Fluidextractum  Eucalypti. 
Fluidextract  of  Eucalyptus. 

Average  dose,  H],  xxx.-2  mils. 

Granatum,  Pomegranate. 

The  bark  of  the  pomegranate  root  contains  four 
alkaloids,  which  are  combined  in  the  standard  prepa- 
ration, called  pelletierine.  The  drug  is  an  efficient 
taeniacide,  or  remedy  for  tapeworm.  It  is  capable  of 
causing  symptoms  of  some  severity,  such  as  muscular 
depression  almost  amounting  to  paralysis,  and  it  is  not 
considered  a  safe  drug  for  children.  The  taste  is  very 
unpleasant.  In  administration  the  patient  fasts  for 
twelve  or  eighteen  hours  previously  to  taking  the  dose. 
The  decoction  of  the  fresh  root  is  used  in  a  strength  of 
two  ounces  to  a  pint  of  water.  This  quantity  is  divided 
foto  several  doses,  and  taken  at  intervals  of  an  hour. 


THE  VEGETABLE  KINGDOM.        2OI 

Pelletierine  tannate  is  given  in  the  same  way.  A 
cathartic  is  given  afterwards,  no  food  being  allowed 
until  the  treatment  is  over. 

Pelletierinae  Tannas. 
Pelletierine  Tannate. 

Average  dose  of  pelletierine  tannate,  gr.  iv.-o.25  Gm. 

Caryophyllus,  Cloves. 

The  unopened  flowers  of  Eugenia  aromatica,  a  tree 
of  the  Molucca  Islands.  The  spice  made  from  them 
contains  oleum  caryophyllse,  or  oil  of  cloves,  a 
pungent,  volatile  oil.  It  is  aromatic  and  carmina- 
tive, and  locally  to  some  extent  anaesthetic,  as  shown 
by  its  popular  use  in  the  cavity  of  an  aching  tooth. 
Clove  tea  is  made  with  spice  and  boiling  water,  3 
ii.-O.i. 

Jambul.     Not  official. 

The  drug  obtained  from  the  bark  of  Eugenia  jam- 
bolana,  an  Hast  Indian  tree,  is  used  in  India  as  a 
stomachic  astringent,  and  also  as  a  specific  in 
diabetes. 

Average  dose  of  the  fluid  extract,  Til  x.-i  Gm. 

Fam.  Cucurbitacece. 
Colocynthis,  Colocynth. 

The  dried,  peeled,  and  seeded  fruit  of  Citrullus 
Colocynthis,  or  bitter  cucumber,  from  Eastern  coun- 
tries. The  active  principle  is  colocynthin. 

Colocynth  is  a  powerful  hydragogue  and  drastic 
cathartic,  irritant,  and  quickly  acting,  causing  large 
watery  evacuations,  with  griping  pains  and  general 
depression.  Besides  acting  as  a  stimulant  to  the 
muscular  coat  of  the  intestines,  it  also  acts  on  the  in- 
testinal glands  and  on  the  liver.  To  avoid  the  severity 
of  its  effects,  it  is  always  given  in  combination,  and  is 


202  MATERIA   ME  DIG  A   FOR  NURSES. 

not  suitable  as  an  habitual  purgative,  being  irritant  to 
the  stomach  as  well  as  to  the  bowels. 

Gastro-enteritis  is  caused  by  colocynth  in  poisonous 
quantity,  and  death  has  resulted  in  twenty-four  hours 
from  a  dose  of  3  i.-  3  iii.  of  the  powder. 

Preparations. 

Extractum  Colocynthidis. 
Extract  of  Colocynth. 

Average  purgative  dose,  gr.  £-0.03  Gin. 

Extractum  Colocynthidis  Compositus. 
Compound  Extract  of  Colocynth. 

Contains  extract  of  colocynth,  aloes,  scammony,  and 
cardamom. 

Average  laxative  dose,  gr.  ii. -0.125  Gm. 
Average  purgative  dose,  gr.  iv.-o.25  Gm. 

Pilulae  Catharticae  Compositae. 
Compound  Cathartic  Pills. 

Contain    extract    of    colocynth,     mild    mercurous 
chloride,  extract  of  jalap,  and  gamboge. 
Dose,  i  or  ii  pills. 

Pilulae  Catharticae  Vegetabiles.    Not  official. 
Vegetable  Cathartic  Pills. 

Contain  compound  extract  of  colocynth,  extract  of 
hyoscyamus,  jalap,  leptandra,  and  resin  of  podo- 
phyllum. 

Elaterinum,  Elaterin. 

Blaterium  is  a  sediment  obtained  from  the  juice  of 
the  fruit  oiEcballium  Elaterium.  It  contains  a  neutral 
active  principle,  elaterin,  which  is  the  official  prepara- 
tion, elaterium  being  of  variable  strength. 

The  most  active  hydragogue  cathartic  known, 
producing  excessive  watery  evacuations  in  a  very 
short  time.  If  the  dose  is  not  too  large  there  is  little 
or  no  pain  or  irritation,  although  in  excess  it  is  a 


THE    VEGETABLE  KINGDOM.  203 

gastrointestinal  irritant.  It  is  also  irritant  if  applied 
to  the  skin.  The  purgative  action  of  elaterium  is 
exhausting,  and  the  condition  of  the  patient  must  be 
watched.  Catharsis  is  also  produced  when  it  is  in- 
jected hypodermically,  but  it  cannot  be  safely  used  in 
this  way,  as  it  is  very  irritant  to  the  tissues,  and  has 
been  followed  by  tetanus. 

Preparations. 

There  is  no  official  preparation  of  elaterium,  but  only 
of  its  active  principle. 

Elaterinum. 
Elaterin. 

Average  dose,  gr.  2*9-0.003  ^m- 
Trituratio  Elaterini. 
Trituration  of  Elaterin. 

Strength  i  to  10.     Dose,  gr.  ss.-o.o3  Gm. 

Pepo,  Pumpkin  Seed. 

The  seeds  of  Cucurbita  Pepo,  or  ordinary  pumpkin, 
are  useful  as  a  remedy  for  tapeworm,  being  considered 
more  efficient  than  Felix  mas,  and  quite  harmless. 
The  dose  of  the  expressed  oil  is  half  an  ounce,  given 
in  three  doses  on  an  empty  stomach,  the  patient  having 
fasted  on  the  day  before;  or  two  ounces  of  the  seeds 
may  be  beaten  into  an  emulsion  with  sugar  and  water 
and  taken  with  the  same  precaution.  A  cathartic 
follows. 

Fam.  Umbellifera. 

Conium  (Spotted  Hemlock).    Not  official. 

The  fruit  and  flowers  of  Conium  maculatum,  belong- 
ing to  Europe  and  naturalized  in  the  United  States. 
They  have  an  odor  resembling  that  of  mice.  The 
active  principle  is  conine,  a  very  volatile  alkaloid, 
freely  soluble  in  alcohol  and  ether,  and  slightly  so  in 
water.  On  exposure  to  the  air  it  decomposes,  and 
this  change  is  assisted  by  heat. 


204  MATERIA   MEDICA   FOR  NURSES. 

Physiological  Actions. 

Conium  is  a  motor  depressant,  paralyzing  the  motor 
nerves  from  below  upward.  It  affects  the  respiratory 
centre,  paralyzing  it.  The  cardiac  and  vascular  cen- 
tres are  not  specially  influenced.  The  brain  is  not 
affected,  but  remains  clear. 

When  conium  is  taken  in  doses  just  large  enough  to 
make  an  impression,  the  first  effect  noticed  is  muscular 
weakness  in  the  legs.  The  feet  feel  weighted  down, 
or  as  if  made  of  lead;  the  knees  weak  and  unable  to 
bear  the  body,  giving  an  intense  desire  to  lie  down, 
and  the  patient  cannot  walk,  but  staggers  and  falls. 

The  eyelids  are  affected  and  drop  over  the  eyes;  the 
vision  is  disordered,  and  there  is  frontal  headache,  with 
a  feeling  of  heat,  as  of  weight  and  pressure,  in  the  head. 

Conium  is  also  a  gastric  irritant,  producing  nausea 
and  vomiting. 

It  is  employed  medicinally  as  a  calmative  and  anti- 
spasmodic,  but  its  uncertain,  inexact  strength  is 
considered  to  make  it  unreliable. 

Symptoms  of  Poisoning. 

In  serious  poisoning  the  symptoms  mentioned  above 
are  all  intensified.  The  pupils  dilate;  the  pulse,  at 
first  diminished,  afterwards  becomes  more  rapid.  The 
respiratory  centre  is  paralyzed,  and  death  results  from 
asphyxia  in  a  very  short  time — in  one  case  in  a  few 
moments.  There  are  but  few  recorded  cases  of  fatal 
poisoning.  Hemlock  was  the  State  poison  of  Athens 
in  the  time  of  Socrates,  and  the  means  of  his  death. 

Treatment  of  Poisoning. 

No  physiological  antidote  to  conium  is  known.  The 
stomach  must  be  emptied  and  tannic  acid  given,  stim- 
ulants employed  and  external  heat  applied,  and  arti- 
ficial respiration  practised  as  long  as  there  is  any  heart 
action. 


THE  VEGETABLE  KINGDOM.       2O$ 

Preparations. 

Fluidextractum  Conii.    Not  official. 
Fluidextract  of  Conium. 

Average  dose,  TU.  iii.-o.2  mil. 

Although  this  is  regarded  as  the  best  preparation  of 
conium,  yet  it  is  very  uncertain,  because  of  the  volatile 
character  of  the  essential  principle. 

Asafcetida,  Asafetida. 

A  gum  resin  obtained  by  incising  the  root  of  different 
species  of  Ferula,  of  Afghanistan.  It  contains  a  vola- 
tile oil,  a  resin,  and  gum.  The  oil  is  complex,  but 
consists  largely  of  the  essential  oil  of  garlic,  to  which 
it  owes  its  unpleasant  odor.  The  resin  also  yields 
sulphur. 

Physiological  Actions. 

Asafoetida  has,  in  the  stomach  and  alimentary  canal, 
the  stimulant  and  disinfectant  action  belonging  to 
volatile  oils  and  resins;  but,  while  most  others  are 
pleasant  to  the  taste,  it  is  exceedingly  nauseous  and 
disagreeable.  The  mental  influence  of  this  nauseous 
impression,  combined  with  its  physiological  action, 
renders  asafcetida  a  nerve  stimulant,  an ti spasmodic, 
and  calmative  in  hysterical  conditions. 

It  is  a  carminative,  and  in  enemata  dispels  gas, 
stops  convulsions,  and  relieves  constipation.  It  has 
some  slight  action  as  a  stimulant  and  disinfectant 
expectorant.  The  volatile  oil  is  excreted  by  the 
urine,  perspiration,  and  breath. 

Preparations. 

Pilulse  Asafcetidae. 
Pills  of  Asafetida. 

Each  pill  contains  i  Gtn.  of  the  drug.     Dose  a  pilte. 


206  MATERIA    MEDIC  A    FOR  NURSES. 

Emulsum  Asafcetida?. 
Emulsion  of  Asafetida. 

Average  dose,  1  ss.-i5  mils. 
Tinctura  Asafoetidae. 
Tincture  of  Asafetida. 

Strength,  20%.     Dose,  TTJ,  v.-i  mil. 

Fam.  Caprifoliacea. 
Viburnum  Prunifolium,  Black  Haw. 

Viburnum  acts  upon  the  nerve  centres  of  the  uterus 
and  ovaries  as  a  sedative  and  tonic,  and  is  given  to 
correct  pain  and  irritation  arising  from  these  sources. 

Viburnum  opulus  is  useful  in  the  same  way. 

Average  dose  of  the  fluid  extract,  IT],  xxx.-2  mils. 

Fam  Rubiacea. 
Cinchona. 

The  trees  belonging  to  the  genus  Cinchona  are  found 
native  in  South  America,  on  mountains  at  a  height  of 
5000  to  10,000  feet,  and  they  are  being  successfully 
cultivated  in  other  countries.  The  bark  is  the  part 
used  in  medicine. 

There  are  many  varieties  of  the  tree,  the  most  im- 
portant being  Cinchona  succirubra,  from  which  "red 
bark"  is  obtained,  and  Cinchona  calisaya,  from  which 
comes  the  "yellow"  or  "calisaya  bark."  A  bark 
called  "pale  bark"  is  obtained  from  two  minor  vari- 
eties, and,  finally,  under  the  general  name  "cinchona" 
or  "Peruvian  bark"  are  included  all  other  varieties  of 
the  tree  yielding  two  or  three  per  cent,  of  the  alkaloids 
which  contain  crystallizable  salts. 

Cinchona  contains  four  principal  alkaloids:  quinine, 
the  most  important;  quinidine,  the  strongest  anti- 
periodic,  but  existing  in  very  small  quantities;  cincho- 
nine,  about  half  the  strength  of  quinine;  and  cinchoni- 
dine,  a  little  stronger  than  cinchonine. 


THE    VEGETABLE  KINGDOM.  2O/ 

The  yellow  bark  contains  most  quinine,  the  pale 
bark  most  cinchonine,  and  the  red  bark  about  equal 
quantities  of  each.  Besides  these  important  alkaloids 
and  a  number  of  unimportant  ones,  cinchona  bark 
contains  tannic  and  other  acids,  a  resinous  substance, 
coloring  matter,  etc. 

Physiological  Actions. 

The  preparations  of  cinchona  bark  as  a  whole  are 
used  as  bitter  stomachics  and  tonics. 

They  are  too  bulky  to  be  used  as  antipyretics  or 
antiperiodics  if  quinine  can  be  obtained.  They  have 
some  astringent  action,  due  to  the  tannin  they 
contain.  They  should  be  given  half  an  hour  before 
meals. 

Preparations. 

Tinctura  Cinchonas. 
Tincture  of  Cinchona. 

Strength,  20%.     Average  dose,  3  i.-4  mils. 

Tinctura  Cinchonas  Composita. 
Compound  Tincture  of  Cinchona. 

Contains  cinchona,  glycerin,  bitter  orange-peel,  ser- 
pentaria,  and  alcohol.  Average  dose,  3  i.~4  mils. 

Fluidextractum  Cinchonas. 
Fluidextract  of  Cinchona. 

Average  dose,  T\[  xv.-i  mil. 

The  sulphates  of  cinchonine  and  cinchonidine  are  also 
official.  Average  dose,  gr.  iiss.-o.i5  Gm. 

Quinina,  Quinine. 

Quinine  is  prepared  from  the  powdered  cinchona 
bark  by  various  chemical  processes,  in  the  course  of 
which  an  alkali  and  sulphuric  acid  are  both  used. 

Alkalies,  and  their  carbonates,  and  tannic  acid  are 


208  MATERIA   MEDICA   FOR  NURSES. 

incompatible  with  quinine  and  the  other  alkaloids  of 
cinchona.  The  alkalies  precipitate  them  from  solution, 
and  tannin  forms  with  them  insoluble  compounds. 
One  grain  of  dilute  sulphuric  acid  will  dissolve  one 
grain  of  quinine. 

Physiological  Actions. 

Quinine  arrests  some  processes  of  fermentation  and 
decomposition,  and  might,  except  for  its  cost,  be  used 
as  a  local  antiseptic  and  disinfectant.  It  is  readily 
absorbed,  and  is  frequently  given  by  rectum;  it  is  also 
used  hypodermically,  though  it  is  very  irritating  and 
liable  to  produce  abscesses. 

In  small  doses  it  is  a  powerful  bitter  stomachic  and 
general  tonic,  stimulating  digestion  and  increasing 
appetite.  In  large  doses  it  may  irritate  and  cause 
nausea  and  vomiting,  or  even  gastritis. 

Quinine  may  be  found  in  the  blood  a  few  minutes 
after  being  taken,  and  retards  oxygenation.  It  enters 
the  tissues  quickly  and  is  excreted  slowly,  several 
days  being  required.  The  maximum  effect  of  a  large 
dose  is  reached  in  about  five  hours.  Small  doses 
quicken  the  heart  and  raise  the  blood  pressure.  Large 
ones  depress  the  heart,  diminish  the  force  and  fre- 
quency of  its  contractions,  and  lower  blood  pressure. 
The  respirations  are  also  depressed  by  large  doses. 

Quinine  acts  strikingly  on  the  nerve  centres.  Small 
doses  stimulate  the  brain  and  increase  the  activity  of 
the  mind,  while  slight  overdoses  produce  headache 
and  ringing  in  the  ears,  with  deafness,  more  or  less 
pronounced.  This  deafness  usually  passes  off  quickly, 
but  may  be  permanent.  Full  doses  intensify  these 
symptoms,  and  cause  severe  pain,  constriction,  and 
fulness  in  the  head,  confusion  of  the  mental  faculties, 
intense  nervous  irritability,  giddiness,  disorders  of 
vision,  and  general  prostration  from  depression  of  the 
spinal  cord  and  circulation. 

The  pre-eminent  power  of  quinine  is  shown  in  its 
control  over  malarial  poisoning  as  a  specific,  anti- 
periodic,  and  prophylactic.  (A  medicine  to  be  pro- 


THE    VEGETABLE  KINGDOM.  209 

phylactic  must  belong  either  to  the  class  of  restoratives, 
supplying  a  deficiency  of  some  natural  and  essential 
condition  of  the  body,  or  to  the  class  of  germicides, 
preventing  disease  by  destroying  the  injurious  agent.) 
Quinine  has  some  power  as  an  oxytocic,  contracting 
the  uterus.  In  times  past  it  was  taught  that  it  was 
capable  of  producing  abortion,  but  the  weight  of  evi- 
dence is  believed  by  most  authorities  to  be  against  this 
theory. 

Incidental  Effects. 

Eruptions  of  the  skin  are  sometimes  observed  after 
the  use  of  quinine,  even  in  small  doses.  A  rash  re- 
sembling that  of  scarlet-fever  may  appear,  followed  by 
severe  itching  and  smarting,  and  desquamating  finally. 

More  rarely  the  eruption  resembles  urticaria,  popu- 
larly known  as  "hives  "  or  " nettle- rash."  Occasionally 
irritation  of  the  urinary  organs  is  caused,  with  pain, 
congestion  of  the  kidneys,  or  even  hemorrhage.  This 
is  more  liable  to  occur  with  old  people.  Idiosyncrasy 
exists  in  a  marked  degree  with  some  persons  in 
regard  to  quinine,  forbidding  the  use  of  even  the 
smallest  doses. 

If  much  prostration  follows  the  administration  of 
quinine,  strong  black  coffee  with  brandy  is  the  best 
antidote.  In  giving  quinine,  ringing  in  the  ears  and 
deafness  are  the  first  symptoms  to  be  looked  for. 

There  are  now  eight  official  preparations  of  quinine 
— Quinine  Bisulphate,  Dihydrochloride,  Hydrobromide, 
Hydrochloride,  Salicylate,  Sulphate,  and  Tannate,  all 
of  which  except  the  last  have  an  average  dose  of  gr. 
1 3-0. i  Gm.  as  tonics,  and  gr.  xv.-i  Gm.  daily  as  anti- 
malarial  remedies.  The  dose  of  the  tannate  is  gr.  iii.- 
0.2  Gm. 

I^ast  is  a  preparation  for  hypodermic  use,  Quinine 
and  Urea  Hydrochloride.  Average  daily  dose,  gr. 
xv.-i  Gm. 

Quinine  is  usually  given  in  pills  or  capsules  on 
account  of  the  bitter  taste.  Sometimes,  when  rapid 
action  is  desired,  it  is  given  in  solution.  The  taste  is 
14 


210  MATERIA  MEDICA  FOR  NURSES. 

very  persistent  and  is  better  removed  by  a  piece  of  dry 
bread,  or  an  olive,  than  anything  else.  The  powdered 
sulphate  may  be  given  in  sherry  wine. 

Quinine  pills  should  not  be  more  than  ten  days  old, 
as  then  they  become  so  dry  and  hard  as  to  be  useless, 
passing  through  the  alimentary  canal  without  dissolv- 
ing. Quinine  should  be  given  on  an  empty  stomach, 
or  after  the  process  of  digestion  is  partly  over.  If  a 
patient  is  on  milk  diet  quinine  should  not  be  given  in 
solution  near  the  milk,  as  it  is  very  liable  to  cause 
vomiting.  Otherwise  there  is  no  incompatibility  be- 
tween quinine  and  milk. 

Warburg's  Tincture.   Not  official. 

A  preparation  with  an  exceedingly  long  formula, 
containing  over  a  dozen  drugs  of  vegetable  origin,  with 
a  certain  proportion  of  quinine,  the  most  active  in- 
gredient (between  9  and  10  grains  to  the  ounce).  It  is 
used  as  a  diaphoretic,  and  is  best  given  at  night. 

Dose,  §  ss.-i5  mils. 

Ipecacuanha,  Ipecac. 

The  dried  root  of  Cephaelis  Ipecacuanha ,  of  Brazil. 
Ipecac  contains  from  \  to  i  %  of  the  active  principle, 
emetine,  and  also  a  glucoside,  starch,  gum,  etc. 

Physiological  Actions. 

Externally,  powdered  ipecac  irritates  the  skin,  caus- 
ing a  pustular  eruption.  Mucous  membranes  are 
similarly  irritated,  and  an  increased  bronchial  and 
nasal  secretion,  sneezing,  etc.,  follows  its  local  applica- 
tion. Taken  internally,  it  tends  to  soften  and  liquefy 
hard  and  tenacious  mucous  secretions. 

In  the  stomach  ipecac  in  very  small  doses  (gr.  })  is 
a  gastric  stimulant,  increasing  local  circulation  and 
secretion.  In  these  minute  doses  it  checks  vomiting. 

In  large  doses  it  is  a  familiar  emetic,  safe  and 
prompt,  and  non-depressing.  Its  action  is  partly 
direct  and  partly  indirect,  the  act  of  vomiting  being 
promoted  both  by  local  action  on  the  stomach  walls, 


THE    VEGETABLE  KINGDOM.  211 

and  by  stimulation  through  the  influence  of  emetine  of 
the  vomiting  centre  in  the  medulla. 

The  emesis  caused  by  ipecac  takes  place  in  from 
twenty  to  thirty  minutes  after  administration,  and 
occurs  usually  only  once.  There  is  but  very  little 
nausea  before  or  with  the  act  of  vomiting,  nor  is  it 
followed  by  exhaustion.  It  is  accompanied  by  a 
decided  increase  in  the  secretions  of  the  gastric  and 
bronchial  mucous  membranes,  and,  the  sputum  thus 
being  made  more  fluid,  with  the  expulsive  act  there  is 
a  general  clearing  out  of  the  bronchial  tubes,  the 
trachea,  and  the  nasal  cavities. 

Ipecac,  as  an  emetic,  is  between  sulphate  of  zinc  and 
tartar  emetic,  not  being  as  prompt  as  the  first,  nor  as 
nauseating  as  the  second.  It  is  not  powerful  enough 
to  give  alone  in  cases  of  poisoning,  but  is  then  used  as 
an  aid  to  other  emetics.  It  is  very  suitable  for  child- 
ren, and  they  bear  it  in  relatively  large  doses. 

Ipecac  is  a  sedative  expectorant,  a  direct  chol- 
agogue,  increasing  the  flow  of  bile,  and  a  diaphoretic. 

Preparations. 

Pulvis  Ipecacuanhas  et  Opii. 

Powder  of  Ipecac  and  Opium.  -See  Opium. 

Average  dose,  gr.  xv.-i  Gm. 
Syrupus  Ipecacuanhas. 
Syrup  of  Ipecac. 

Strength,  7  parts  fluid  ext.  to  100.    Dose,  expectorant, 
TTl  xv.-i  mil;  emetic,  3  iv.-i5  mils. 
Vinum  Ipecacuanhas.    Not  official. 
Wine  of  Ipecac. 

Strength,  i  part  fluid  ext.  to  8  white  wine.     Dose, 
Til  x.-xx.     (0-65-1.3  mil.) 
Fluidextractum  Ipecacuanhas. 
Fluidextract  of  Ipecac. 

Average  expectorant  dose,  fU  i.-o.o5  mil. 
Emetic  dose  for  adult,  TH,  xv.-i  mil. 


212  MATERIA   MEDIC  A    FOR  NURSES. 

Emetinae  Hydrochloridum. 
Emetine  Hydrochloride. 

Average  dose,  gr.  £-0.02  Gm. 

All  these  preparations  are  best  given  with  plenty  of 
warm  water,  in  cases  of  poisoning;  with  croupy  child- 
ren, however,  swallowing  being  difficult,  it  is  best  not 
to  dilute  the  dose,  or  but  very  little. 

Coffea  Arabica  (Coffee  Plant). 

The  seeds  of  the  cofiee  plant,  grown  in  Arabia,  yield 
the  alkaloid  caffeine  (which  is  also  obtained  from 
plants  belonging  to  different  families,  viz.,  Paullinia 
sorbilis,  guarana).  The  coffee  seeds  also  contain 
sugar,  tannic  acid,  caffeic  acid,  a  volatile  oil,  etc. 

The  qualities  of  coffee  as  a  beverage  are  too  familiar 
to  need  mention.  In  moderation,  and  when  well  made, 
it  aids  digestion  and  has  laxative  effect.  In  excess, 
or  when  improperly  made  and  allowed  to  boil,  it 
causes  dyspepsia  by  the  astringent  action  of  its  tannic 
acid.  The  plant  itself  is  not  official,  but  its  alkaloid  is  so. 

Caffeina. 
Caffeine.    Theinc. 

Caffeine  is  distinguished  by  containing  more  nitrogen 
than  almost  any  other  vegetable  principle.  It  is 
absorbed  unchanged  into  the  circulation,  and  is  a 
stimulant  to  the  brain  and  heart,  producing  wakeful 
ness,  with  a  clear,  vigorous  state  of  the  intellect,  and 
strengthening  the  contraction  of  the  heart. 

It  resembles  digitalis  in  its  action  as  a  cardiac  stimu- 
lant, but  acts  more  promptly  and  is  more  transitory  in 
its  effects. 

It  has  no  decided  cumulative  tendency,  and  does  not 
disagree  with  the  stomach.  It  acts  as  a  diuretic  by 
stimulating  the  cells  of  the  kidneys,  as  well  as  by  its 
action  on  the  heart  and  circulation. 

It  has  been  known  to  cause,  after  doses  of  moderate 
size,  nervous  wakefalness  and  restlessness,  treinulous- 
oess,  frequent  pulse,  confused  thought,  and  visions 


THE    VEGETABLE  KINGDOM.  213 

passing  In  a  constant  train.  These  symptoms  have 
lasted  for  several  hours. 

In  large  doses  it  has  caused  poisonous  though  never 
fatal  symptoms,  such  as  muscular  tremor,  a  burning 
feeling  in  the  throat,  palpitations  with  rapid,  violent 
pulse  and  short,  quick  respirations;  giddiness,  nausea, 
disordered  vision,  and  marked  diuresis. 

Average  dose  of  caffeine,  gr.  iiss.-o.i5  Gm. 

Official  preparations  of  caffeine  are  the  Citrated 
Caffeine,  Effervescent  Citrated  Caffeine,  and  Caffeine 
Sodio-Benzoate. 

Fam.  Ternstromiacea . 
Camellia  Thea  (Tea  Plant).    Not  official. 

The  leaves  of  the  tea  plant,  grown  in  China,  contain 
theine,  the  active  principle;  tannic  acid,  and  a  volatile  oil. 

Tea  is  stimulating  and  refreshing.  Used  to  excess 
it  weakens  the  digestive  system  and  causes  constipa- 
tion, depresses  the  heart  and  vase-motor  nerves,  pro- 
ducing neuralgic  pains.  In  cases  of  poisoning,  when 
tannin  is  needed,  it  may  sometimes  be  most  quickly 
procured  in  the  form  of  strong,  rank  tea.  By  boiling 
it  hard  and  squeezing  dry  the  leaves,  the  tannin  is 
extracted  as  thoroughly  as  possible,  and  the  tea  is 
given,  without  sugar  or  milk,  in  large  quantities. 

Fam    Valerianaceee. 
Valeriana,  Valerian. 

The  dried  rhizome  and  roots  of  Valeriana  officinalis. 
The  active  principles  are  a  volatile  oil  and  valerianic 
*cid.  The  latter  is  found  in  many  other  plants,  in 
cod-liver  oil,  and  may  be  derived  from  amylic  alcohol. 

Valerian  is  a  carminative,  circulatory  stimulant, 
and  antispasmodic.  In  nervous  cases  it  sometimes 
acts  successfully  as  an  hypnotic.  Large  doses  (  3  ii.- 
iv.)  may  cause  nausea,  vomiting,  and  colic,  a  quick- 
ened pulse,  and  a  feeling  of  formication  in  hands  and 
feet 


214  MATERIA   ME  DIG  A  FOR  NURSES. 

Preparations. 

Tinctura  Valerians. 
Tincture  of  Valerian. 

Strength  20%.    Average  dose,   3  i.~4  mils. 

Tinctura  Valerians  Ammoniata. 
Ammoniated  Tincture  of  Valerian. 

Strength  20%.     Average  dose,  TT[  xxx.-2  mils. 

Fluidextractum  Valerians.     Not  official. 
Fluidextract  of  Valerian. 

Dose,  3  i-    (4  mils.) 

Fam.  Composite. 
Santonica  (Levant  Wormseed). 

The  dried  flower-heads  of  Artemisia  paudflora,  of 
Asia  Minor.  The  active  principle  is  santonin,  and 
there  is  also  a  compound  volatile  oil  resembling  cam- 
phor in  its  action. 

Santonin  is  an  anthelmintic,  acting  especially  on 
the  ascaris  lumbricoides,  or  round  worm.  In  overdoses 
it  produces  disturbances  of  vision  and  of  consciousness. 
Objects  appear  at  first  to  be  blue,  then  yellow.  There 
are  tremors,  aphasia,  and  sometimes  convulsions.  The 
respirations  become  feeble,  and  the  pulse  is  reduced. 

It  is  necessary,  in  giving  it,  to  watch  its  action,  that 
these  symptoms  may  be  avoided. 

It  is  excreted  by  the  bowels  and  by  the  kidneys,  and 
discolors  the  urine,  making  it  saffron  or  reddish. 
There  have  been  numerous  cases  of  fatal  poisoning 
among  children  from  santonin.  Alarming  symptoms 
have  been  caused  by  gr.  ii.  in  a  child  eight  years  old, 
and  a  dose  of  gr.  ii.  to  a  child  of  five  years  caused 
death. 

Santoninum. 
Santonin. 

Average  dose,  gr.  i.-o.o6  Gin. 


THE  VEGETABLE  KINGDOM.  21$ 

Eupatorium  (Thoroughwort).    Not  official. 

The  herbal  parts  of  a  coarse  plant  yield  this  drug, 
whose  chief  action  is  as  a  sudorific.  The  infusion  is 
given  very  hot,  in  doses  of  one  half  or  one  tumbler  full, 
the  patient  being  warmly  covered  in  bed,  and  free 
diaphoresis  results.  The  taste  is  very  unpleasant. 

Taraxacum,  Dandelion. 

The  root  of  the  dandelion  is  a  simple  bitter  and 
mild  laxative. 

Fluidextractum  Taraxaci. 
Fluidextract  of  Taraxacum. 

Average  dose,  3  iiss.-io  mils. 

Arnica,  Arnica  Flowers. 

The  Atnica  montana,  or  leopard's  bane,  grows  in 
Northern  Kurope  and  Asia  and  in  the  Northwestern 
United  States.  The  dried  flower  heads  contain  alka- 
loids, an  essential  oil,  resins,  and  an  ammonia  com- 
pound, trimethylamine,  none  of  which  are  separately 
recognized  by  the  U.  S.  P. 

Externally  arnica  is  stimulating  and  irritant, 
increasing  the  circulation  of  the  skin.  It  sometimes 
causes  excessive  redness,  and  eczema,  and  must  be  used 
with  care. 

The  diluted  tincture  promotes  the  absorption  of 
blood  which  has  effused  into  the  tissues,  as  after  a 
blow,  and  prevents  swelling. 

Internally,  in  small  doses,  arnica  is  slightly  stimulat- 
ing to  the  heart,  the  skin,  and  kidneys. 

In  larger  doses  it  is  a  cardiac  depressant,  and  in 
doses  equal  to  §  i.  of  the  tincture  it  has  caused  the 
poisonous  symptoms  of  gastro-intestinal  irritation; 
cold  dry  skin;  feeble  fluttering  pulse,  lowered  some- 
times to  60;  and  occasionally  vomiting  and  purging, 
with  final  collapse.  It  should  never  be  applied  to  an 
open  wound. 


2l6  MATERIA  MEDIC  A  FOR  NURSES. 

Preparations. 

Tinctura  Arnicas. 
Tincture  of  Arnica. 

Strength,  20  %. 

This  preparation  used  externally  must  be  diluted, 
applied  on  a  piece  of  flannel  to  the  inflamed  part,  and 
covered  with  a  bandage. 

Average  dose,  TT[  xv.— i  mil. 

Grindelia. 

The  leaves  and  flowering  tops  of  a  California  plant. 
It  is  a  stimulant  expectorant  and  a  diuretic;  in 
large  doses  depressant,  causing  nausea  and  vomiting, 
and  lowering  the  rate  of  the  heart,  temperature,  and 
respirations.  It  is  sometimes  used  as  an  inhalation. 

In  cases  of  poisoning  by  Rhus  toxicodcndron,  or  poison 
ivy,  it  is  said  to  be  an  excellent  remedy,  the  fluid  extract 
being  applied  locally,  largely  diluted. 

Average  dose  of  the  fluid  extract,  TT|,  xxx.-2  mils. 

Fam.  Lobeliacecs. 
Lobelia,  Indian  Tobacco. 

The  leaves  and  tops  of  Lobelia  inflata,  of  the  United 
States. 

Lobelia  is  a  motor-depressant  and  anti-spas- 
modic. In  small  doses  it  stimulates  the  alimentary 
canal,  and  in  full  doses  irritates  it,  causing  pain,  vomit- 
ing, purging,  and  general  depression. 

I^arge  doses  cause,  in  addition,  cold  sweats,  muscular 
tremors,  feeble  pulse,  and  stupor,  with  coma  and  col- 
lapse. It  has  frequently  caused  death,  which  occurs 
by  paralysis  of  the  respiratory  centre.  It  is  very 
seldom  used,  on  account  of  its  very  depressing  action. 

The  treatment  of  poisoning  consists  in  washing  out 
the  stomach  with  a  warm  solution  of  tannic  acid  (or 


THE    VEGETABLE  KINGDOM.  2 1/ 

warm,  strong  tea),  the  application  of  external  heat, 
and  stimulation  by  mustard,  friction,  etc.;  and  the  use 
of  alcoholic  stimulants,  ammonia,  and  opium. 

Preparations. 

Tinctura  Lobeliae. 
Tincture  of  Lobelia. 
Strength,  10%.    Average  dose,  TTI  xv.-i  mil. 

Fluidextractum  Lobeliae. 
Fluidextract  of  Lobelia. 

Average  dose,  TTJ,  iiss.-o.i5  mil. 

Fam.  Styracacea . 
Benzoinum,  Benzoin. 

The  thickened  juice  of  Sty  rax  Benzoin,  an  Eastern 
tree.  It  is  soluble  in  alcohol;  not  readily  soluble  in 
water.  Benzoin  is  a  balsamic  resin,  containing  from 
12  to  15  %  of  benzoic  acid.  It  is  antiseptic  and  disin- 
fectant, and  is  said  to  have  more  power  than  salicylic 
acid  to  destroy  bacteria  and  prevent  putrefaction. 

Applied  to  the  skin,  it  has  a  stimulating  and  heal- 
ing action.  Inhaled,  or  applied  in  solid  form  to  the 
nose,  it  irritates  the  nasal  and  bronchial  mucous  mem- 
branes, but  in  proper  solution  acts  on  them  only  as  a 
gentle  stimulant.  Taken  internally  it  is  diaphoretic, 
increases  the  urine  and  makes  it  more  acid,  and  raises 
the  pulse  rate.  It  is  excreted  by  the  kidneys,  partly 
as  hippuric  acid,  and  partly  unchanged. 

Preparations. 

Acidum  Benzoicum. 
Benzoic  Acid. 

Average  dose,  gr.  viii.-o.5  Gm. 
Tinctura  Benzoini. 
Tincture  of  Benzoin. 

Strength,  20%.     Average  dose,  fit  xv.-i  mil. 


218  MATERIA  MEDICA  FOR  NURSES. 

Tinctura  Benzoini  Composita. 
Compound  Tincture  of  Benzoin. 

For  external  use;  it  contains  benzoin,  aloes,  storax, 
balsam  of  tolu,  and  alcohol. 

AmmoniU  _ 

_    ...         fBenzoas. 

Sodn        J 

,  f  Ammonium. 
Benzoateofi  Sodium. 

Average  dose,  gr.  xv.-i  Gm. 

Fam.  OleaceeE. 

Oleum  Olivae,  Olive  Oil. 

The  oil  expressed  from  the  fruit  of  Olea  europ&a. 
Olive  oil  is  composed  of  a  fluid  oil,  olein;  a  solid  oil, 
palmitin;  with  oleic  and  palmitic  acids. 

Used  externally  by  inunction,  it  is  absorbed  by  the 
lymphatics,  and  has  some  nutritive  value. 

As  a  mechanical  application  it  is  used  both  exter- 
nally and  internally  in  the  treatment  of  burns  and 
corrosive  poisons.  It  acts  as  a  laxative,  and  is  used 
for  this  purpose  in  enemata,  tending  to  soften  the  faecal 
mass  and  assist  in  its  expulsion.  Oils  in  general  are 
changed  into  carbonic  acid  arid  water  in  the  system, 
and  so  excreted,  but  an  excess  will  appear  unchanged 
in  the  urine. 

Fam.  Loganiacece. 

Spigelia,  Pink-Root. 

Spigelia  is  an  anthelmintic  and  purgative,  and  acts 
on  the  round  worm. 

Fluidextractum  Spigeliae. 
Fluidextract  of  Spigelia. 

Average  dose,  3  i.~5  mils. 


THE  VEGETABLE  KINGDOM.       219 

Gelsemium,  Yellow  Jessamine. 

The  root  of  Gelsemium  sempervirens,  of  the  Southern 
United  States.  The  alkaloid  gelsemium  and  gelse- 
minic  acid  are  the  important  constituents. 

Physiological  Actions. 

Gelsemium  is  a  motor  depressant  and  antispas- 
modic,  acting  by  direct  influence  on  the  spinal  cord. 
In  medicinal  doses  it  is  sedative  and  diaphoretic. 

The  smallest  active  quantity  (TlJ,  v.-xv.)  causes  a 
languid  feeling,  with  slight  reduction  of  the  strength 
and  frequency  of  the  pulse.  If  the  amount  be  in- 
creased, pain  over  the  eyes,  some  disturbance  of  vision, 
and  dizziness  result,  with  increased  perspiration.  It 
has  a  peculiar  nervous  effect  011  some  people,  making 
them  cry  without  knowing  why. 

Gelsemium  relieves  obscure  pains  and  is  used  in  a 
great  many  quack-cures  for  rheumatism,  which  are 
especially  dangerous  because  of  this  drug  and  the 
ignorance  of  the  laity  in  regard  to  it. 

Symptoms  of  Poisoning. 

Poisonous  doses  (3  i.  of  the  fluidextract)  produce, 
in  addition  to  these  symptoms,  great  muscular  weak- 
ness, affecting  especially  the  flexors  of  the  arms. 

The  gait  also  is  affected,  and  becomes  staggering. 
The  jaw  drops,  and  articulation  fails.  There  is  marked 
effect  on  the  sight:  double  vision,  partial  or  complete 
blindness  may  develop;  sometimes  a  squint  is  pro- 
duced; the  eyelid  droops;  the  pupil  dilates. 

There  is  profuse  perspiration,  cold  surface  and  sub- 
normal temperature,  and  a  condition  of  general  anaes- 
thesia. The  pulse  is  thready  and  feeble,  and  death 
finally  results  from  paralysis  of  the  respiratory  muscles. 
Consciousness  remains  until  carbonic  -  acid  narcosis 
begins  as  the  result  of  asphyxia. 

Gelsemium  is  rapidly  diffused,  and  the  effects  appear 
within  half  an  hour,  and,  after  medicinal  doses,  dis- 
appear within  two  or  three  hours. 


220  MATERIA   ME  DIG  A  FOR  NURSES, 

Death,  when  it  occurs,  may  do  so  in  a  few  hours, 
and  has  been  known  to  result  from  taking  one  sixth  of 
a  grain. 

Treatment  of  Poisoning. 

Poisonous  symptoms  are  treated  by  emetics,  alcoholic 
stimulants,  external  heat,  electricity,  and  artificial 
respiration,  if  necessary. 

Preparations. 

Fluidextractum  Gelsemii. 
Fluidextract  of  Gelsemium. 

Average  dose,  TTJ,  £-0.03  mil. 

Tinctura  Gelsemii. 
Tincture  of  Gelsemium. 

Strength  10%.     Average  dose,  TTJ,  iv.-o.25  mil» 
Nux  Vomica. 

The  seeds  of  Strychnos  nux-vomica>  an  East  Indian 
tree.  The  active  principle  is  the  alkaloid,  strychnine, 
an  important  poison.  Two  other  important  principles 
are  brucine  and  igasuric  acid.  Brucine  is  of  half  the 
strength  of  strychnine. 

Physiological  Actions. 

Nux  vomica  in  medicinal  doses  is  tonic,  with  the 
qualities  of  bitter  stomachics  ;  it  increases  appetite, 
aids  digestion,  and  promotes  peristalsis.  It  also  stim- 
ulates respiration,  the  heart,  and  vaso-motor  centres. 
These  actions  are  largely  due  to  the  presence  and  in- 
fluence of  strychnine.  Strychnine  enters  the  system 
rapidly,  especially  the  nervous  tissues,  on  which  its 
pre-eminent  action,  that  of  a  motor  excitant,  is 
shown.  It  is  excreted  very  slowly,  not  disappearing 
from  the  tissues  for  several  days,  and  therefore  accumu- 
lates in  the  system  when  given  in  continuous  doses, 
even  small  ones. 

The  power  of  strychnine  in  regard  to  the  nervous 


THE    VEGETABLE  KINGDOM.  221 

system  is  exerted  on  the  motor  centres  of  the  spinal 
cord  and  all  the  important  nerve  centres  in  the 
medulla. 

The  first  constitutional  symptoms  are  a  feeling  of 
restlessness,  with  slight  trembling  of  the  extremities. 

After  a  full  dose  (gr.  -fa),  there  are  noticeable  mus- 
cular twitching  and  jerking  of  the  limbs,  slight  stiff- 
ness of  the  jaw,  a  tense  feeling  about  the  head,  stricture 
of  the  throat  and  chest,  shuddering,  and  a  feeling  of 
anxiety. 

Symptoms  of  Poisoning. 

After  poisonous  doses  (gr.  $•  for  an  adult),  violent 
symptoms  come  on  very  suddenly,  probably  within 
fifteen  minutes,  with  tonic  convulsions  resembling  the 
spasm  of  tetanus.  The  legs  are  rigid,  extended,  and 
the  feet  averted,  or  the  body  may  be  bent  backward 
until  the  head  and  heels  meet  (opisthotonos).  The 
arms  are  bent,  and  hands  clinched;  the  eyes  open  and 
staring.  The  corners  of  the  mouth  are  drawn  up  by 
the  muscles  in  a  mechanical  grin,  the  "risus  sar- 
donicus,"  which  gives  a  ghastly  unmeaning  expression, 
and  the  face— at  first  pale — presently  becomes  livid 
from  asphyxia. 

Between  the  paroxysms  there  is  a  period  of  relaxation 
and  quiet,  but  the  slightest  sound,  or  touch,  or  breath 
of  air  brings  on  the  spasms  again  instantly  by  reflex 
action,  owing  to  the  condition  of  intense  irritability. 

In  cases  which  terminate  fatally,  the  spasms  succeed 
each  other  quickly,  and  death  takes  place  in  two  or 
three  hours  from  paralysis  of  the  respiratory  muscles. 
The  mind  usually  remains  clear  up  to  the  last.  Some- 
times asphyxia  produces  insensibility  just  before  death. 

Strychnine  convulsions  resemble  tetanic  and  hys- 
terical convulsions  in  some  particulars.  The  special 
points  of  difference  are  as  follows: 

Strychnine. 

The  convulsions  begin  with  a  restless,  excited  state; 
the  special  senses  are  sharpened.  Muscular  symptoms 


222  MATERIA   MEDICA  FOR  NURSES. 

come  on  very  rapidly,  either  beginning  in  the  ex- 
tremities or  appearing  simultaneously  over  the  body. 
The  jaw  is  the  last  part  affected  and  the  first  relaxed. 
The  eyes  are  open,  and  the  muscles  are  relaxed 
between  the  convulsions. 

Tetanus. 

The  symptoms  come  on  gradually,  with  pain  and 
stiffness  of  the  back  of  the  neck  and  occasional,  slight 
muscular  twitchings.  The  jaw  is  the  first  part 
affected,  and  is  rigid  (trismus,  or  lock-jaw).  There 
is  a  permanent  state  of  general  muscular  rigidity. 

Hysteria. 

Begins  with  weakness  and  blindness.  The  muscular 
symptoms  begin  with  stiffness  of  the  neck.  The 
extremities  are  affected  last.  The  jaw  is  set  before  a 
convulsion  and  remains  fixed  between  them.  The 
eyes  are  closed. 

Treatment  of  Poisoning. 

In  treating  strychnine  poisoning,  tannic  acid  or  a 
soluble  iodine  salt  is  given  as  an  antidote,  followed 
quickly  by  emetics,  as  the  compounds  thus  formed 
are  not  permanent.  The  bladder  must  be  emptied  to 
prevent  re-absorption;  then  absolute  quiet  is  of  the 
greatest  importance.  Inhalations  of  chloroform  are 
used,  with  full  doses  of  chloral  and  bromide  of  potas- 
sium given  internally. 

Precautions. 

In  giving  strychnine,  the  possibility  of  its  cumula- 
tive action  must  always  be  kept  in  mind  as  a  grave 
feature.  It  is  more  likely  to  develop  if  the  medicine 
is  in  pill  form  than  if  in  solution.  With  the  liquid 
preparation  of  iron,  strychnine,  and  quinine,  the  danger 
exists  also  as  the  strychnine  is  apt  to  precipitate.  It 
must  always  therefore  be  well  shaken.  Strychnine 
is  more  effective  with  old  people. 


THE    VEGETABLE  KINGDOM.  22$ 

The  first  constitutional  symptoms  are  to  be  looked 
for  with  care:  twitching,  trembling,  starting,  or  stiff- 
ness of  the  muscles.  It  is  of  great  importance  to 
know  exactly  when  they  begin,  especially  when,  as  is 
often  the  case,  the  orders  received  are  to  push  the 
medicine  to  the  utmost  limit. 

Preparations  of  Nux  Vomica. 

Extractum  Nucis  Vomicae. 
Extract  of  Nux  Vomica. 

Average  dose,  gr.  1-0.015  Gm. 

Tinctura  Nucis  Vomicae. 
Tincture  of  Nux  Vomica. 


Between  0.237  Gm.  and  0.263  Gm.  of  the  alkaloids 
of  nux  vomica  are  contained  in  100  mils  of  tincture. 
Average  dose,  TTJ,  viii.-o.5  mil. 

Fluidextractum  Nucis  Vomicae. 
Fluidextractum  of  Nux  Vomica. 

Average  dose,  Til  1.-O.O5  mil. 

Extractum  Nucis  Vomica. 
Extract  of  Nux  Vomica. 

Average  dose,  gr.  £-0.015  Gm. 

All  preparations  of  nux  vomica  are  given  before 
meals. 


Preparations  of  Strychnine. 

Strychninae  Sulphas. 
Strychnine  Sulphate. 

Average  dose,  gr.  3*5-0.0015  Gm. 

Strychninae  Nitras. 
Strychnine  Nitrate. 

Average  dose,  gr.  ^-0.0015  Gm. 


224  MATERIA   MEDICA   FOR  NURSES. 

Fam.  Gentianacece. 
Gentiana,  Gentian. 

The  root  of  Gentiana  lutea,  the  yellow  gentian  of 
the  Alps,  furnishes  an  efficient  simple  bitter  and 
stomachic  tonic. 

Preparations. 

Tinctura  Gentians  Composita. 
Compound  Tincture  of  Gentian. 

Strength  10%.     Average  dose,  3  i.~4  mils. 

Fluidextractum  Gentians. 
Fluidextract  of  Gentian. 

Average  dose,  TT[  xv.-i  mil. 

Extractum  Gentians. 
Extract  of  Gentian. 

Average  dose,  gr.  iv.-o.25  Gm- 

Fam.  Convolvulacetz. 
Scammonise  Radix.    Scammony  Root. 

The  root  of  Convolvulus  Scammonia  yields  an 
exudate  from  which  is  obtained  a  resin,  having  pro- 
perties as  a  drastic  purgative.  The  chief  ingredient 
of  the  resin  is  called  jalapin,  and  is  probably  the  same 
as  the  convolvulin  of  jalap. 

The  average  dose  of  the  resin  of  scammony  is  gr. 
iii.-o.2  Gm. 

Jalapa,  Jalap. 

Obtained  from  the  dried  tuberous  root  of  Exogo- 
nium  Purga.  The  active  principle  is  a  double  resin, 
or  one  separable  into  two,  called  jalapin  and  con- 
volvulin, the  latter  being  the  more  important.  Jalap 
is  a  hydragogue  cathartic,  and  creates  a  feeling  of 
nausea.  In  overdoses  it  causes  severe  vomiting  and 


THE    VEGETABLE  KINGDOM.  22$ 

purging.  The  stools  produced  by  its  action  are  large 
and  watery.  It  is  seldom  used  alone,  but  is  often 
combined  with  calomel.  Average  dose,  gr.  xv.-i  Gm. 
The  compound  powder,  Pulvis  Jalapae  Compositus, 
contains  jalap  and  cream  of  tartar. 

Fam.  Apocynacea 
Strophanthus. 

The  seeds  of  Strophanthus  hispidus  or  S.  Kombe.  The 
active  principle  is  a  glucoside  named  strophanthin.  It 
exists  in  the  seeds  in  a  strength  of  8  or  10  #. 

Physiological  Actions. 

Strophanthus  enters  the  blood  and  acts  directly  on 
muscular  tissue  as  a  tonic,  increasing  its  contractile 
power,  and,  in  poisonous  doses,  paralyzing  and  leav- 
ing it  in  a  state  of  tetanic- like  spasm, — not  through  the 
agency  of  the  nervous  mechanism,  but  by  direct  in- 
fluence on  the  muscle  itself.  This  tonic  and  stimulant 
action  is  quickly  felt  by  the  heart,  receiving  as  it  does 
in  a  short  time  all  the  blood  of  the  body,  and  thus  feel- 
ing the  action  of  the  whole  amount  of  Strophanthus 
contained  in  it.  The  beats  become  less  frequent  and 
the  cardiac  contractions  strengthened. 

Strophanthus  resembles  digitalis  in  its  action  on  the 
heart,  but  it  is  not  as  lasting  a  stimulant,  though  act- 
ing more  quickly.  It  differs  from  it  also  in  not  affect- 
ing the  vaso-motor  nerves.  It  is  not  irritating  to  the 
alimentary  canal,  and  is  not  cumulative.  It  acts  as  a 
diuretic  by  increasing  the  supply  of  blood  to  the 
kidneys. 

Preparations. 

Tinctura  Strophanthi. 
Tincture  of  Strophanthus. 
Average  dose,  "'U  viii.-o.5  mil. 

Strophanthin,  for  hypodermic  use. 
Average  dose,  gr.  FO-O. 00075  Gm. 


226  MATERIA  MEDICA   FOR  NURSES. 

Fam.  Solanacees. 

Belladonnas  Folia ;  Belladonnas  Radix. 
Deadly  Nightshade. 

The  leaves  and  root  of  Atropa  Belladonna,  a  per- 
ennial plant,  native  of  Great  Britain,  and  cultivated  in 
this  country.  Belladonna  contains  two  alkaloids:  bel- 
iadonine,  of  no  special  importance;  and  atropine,  the 
active  principle,  to  which  the  medicinal  and  poisonous 
properties  of  the  drug  are  owing. 

Physiological  Actions. 

Alone  or  in  a  watery  solution  belladonna  (or  atro- 
pine) is  not  absorbed  by  the  skill,  but  when  combined 
with  alcohol,  glycerin,  or  camphor,  it  is  readily  so 
absorbed,  and  even  more  quickly  by  mucous  mem- 
branes and  inflamed  surfaces;  so  that  physiological 
symptoms,  from  the  first  slight  dry  ness  of  the  throat  to 
evidence  of  severe  poisoning,  may  be  produced  by 
external  applications. 

Used  in  this  way,  belladonna  acts  upon  the  ends  of 
the  sensory  nerves  as  an  anaesthetic,  relieving  pain, 
as  is  seen  in  the  action  of  belladonna  plasters.  This 
sedative  power,  exerted  over  the  nerves  which  control 
the  sweat  glands,  produces  the  familiar  effect  of  drying 
up  the  secretion  of  milk  and  checking  the  action  of  the 
skin. 

Taken  internally,  belladonna  enters  the  blood  and 
reaches  the  tissues  with  rapidity;  and  in  the  case  of 
atropine  alone  absorption  is  even  more  quickly  accom- 
plished. KHmination  takes  place  by  the  urine,  and 
quickly,  atropine  appearing  unchanged  in  from  ten  to 
twenty  hours. 

The  stimulant  and  tonic  powers  of  belladonna, 
which  are  very  strong,  are  exerted  over  the  whole 
sympathetic  system  and  unstriped  or  involuntary 
muscular  fibre;  and  its  sedative,  anodyne  actions 
are  directed  toward  the  motor  system.  It  is  a  mydri* 


THE    VEGETABLE  KINGDOM.  22/ 

atic,  dilating  the  pupils;  an  anti-spasmodic,  and 
the  most  important  respiratory  stimulant  known, 
keeping  up  the  activity  of  the  respiratory  centre  while 
at  the  same  time  allaying  the  irritability  of  the  respira- 
tory nerves. 

It  has  but  little  control  over  severe  pain,  and  is  not, 
strictly  speaking,  an  hypnotic,  though  it  sometimes 
acts  as  one  indirectly  by  removing  conditions  which 
prevented  sleep.  It  has  a  peculiar  effect  on  the  brain, 
causing  excitability,  and  in  large  doses  narcotism. 

As  a  cardiac  stimulant  it  weakens  the  force  of  the 
inhibitory  apparatus,  derived  from  the  cerebro-spinal 
system,  which  retards  the  heart;  and  promotes  the 
activity  of  the  accelerator  apparatus,  derived  from  the 
sympathetic  system,  which  excites  the  heart. 

The  secretion  of  saliva  is  checked  by  belladonna,  and 
this  causes  a  dryness  of  the  mouth  and  throat  which 
is  diagnostic  and  is  watched  for  as  one  of  the  first 
signs  of  constitutional  impression. 

When  small  doses  of  belladonna  or  atropine  are  given, 
the  respirations  become  deeper  and  more  frequent. 
The  pulse,  at  first  slowed  for  a  short  time,  afterwards 
becomes  strong  and  rapid,  its  rapidity  being  somewhat 
out  of  proportion  to  the  rate  of  the  respirations. 

After  full  doses  it  may  rise  as  high  as  twice  its 
former  number  of  beats.  The  small  vessels  are  more 
energetically  contracted,  and  with  the  impetus  to  the 
circulation  the  temperature  rises  |°  or  i°.  The  pupils 
are  dilated  and  vision  disordered;  the  face  flushed;  the 
mouth  and  throat  are  dry;  the  tongue  is  red;  swallow- 
ing is  difficult,  thirst  is  present,  and  a  feeling  as  of  sore 
throat. 

Symptoms  of  Poisoning. 

With  larger  doses  the  flush  becomes  a  uniform  bright 
red,  and  resembles  the  rash  of  scarlet-fever,  except 
that  it  is  not  punctated.1  It  spreads  first  over  face 

Having  the  appearance  of  being  formed  by  exceedingly 
minute  dots  or  points  of  red. 


228  MATERIA   MEDICA   FOR  NURSES. 

and  neck,  extending  perhaps  over  the  whole  body, 
and  is  due  to  a  reaction  and  paralysis  of  the  vaso-motor 
nerves  following  the  primary  stimulation. 

The  pupils  are  bright  and  widely  staring.  Headache 
and  vertigo,  restlessness,  illusions,  and  delirium  ap- 
pear. The  delirium  of  belladonna  is  of  a  peculiarly 
active,  talkative,  busy  type,  accompanied  frequently 
by  laughter  and  gayety  and  associated  with  physical 
lassitude.  The  patient  is  sometimes  absorbed  with 
spectral  illusions  and  visions,  without  showing  any 
fear.  Occasionally  he  becomes  furious,  quarrelsome, 
and  maniacal. 

With  larger  poisonous  doses  there  is  loss  of  muscu- 
lar power,  beginning  in  the  lower  extremities  and 
becoming  complete.  Sensation  is  not  lost.  With  ex- 
cessive poisonous  doses  convulsions  may  appear,  and 
shortly  before  death  stupor  and  paralysis  develop,  and 
the  temperature  becomes  subnormal.  The  urine,  at 
first  increased,  diminishes  and  may  be  entirely  sup- 
pressed. Death  results  from  asphyxia,  from  the  failure 
of  the  respiratory  organs,  and  there  is  heart  failure  as 
well. 

The  smallest  fatal  dose  is  not  positively  known. 
Alarming  symptoms  have  been  produced  by  gr.  -g^-iV 
of  atropine,  and  death  in  fatal  cases  has  occurred  as 
early  as  five  hours  after  taking  the  poison. 

Treatment  of  Poisoning. 

The  first  necessity  is  to  use  emetics  or  the  stomach- 
pump.  The  bladder  must  be  emptied  at  regular  inter- 
vals to  prevent  re- absorption.  Tannic  acid  is  given; 
and  external  heat,  mustard  baths,  hot  and  cold  affu- 
sions to  the  head,  and  artificial  respiration  used. 

Incidental  Effects. 

Medicinal  doses  sometimes  produce  mild  delirium, 
or  a  feeling  of  thirst  and  feverishness.  The  local  ap- 
plication of  the  drug  to  the  eye  sometimes  causes  an 
inflammation  on  the  face  about  the  eyelids.  The  rash 


THE    VEGETABLE  KINGDOM.  22Q 

of  belladonna  may  appear  after  small  doses,  and  may 
desquamate;  and  a  bluish  color  may  be  noticed  on  the 
lips.  The  dryness  of  the  throat  is  always  to  be  looked 
for. 

Preparations  of  Belladonna. 

Tinctura  Belladonnas  Foliorum. 
Tincture  of  Belladonna  Leaves. 

Average  dose,  lit  xii.-o.75  mil. 

Extractum  Belladonnas  Foliorum. 
Extract  of  Belladonna  Leaves. 

Average  dose,  gr.  1-0.015  Gm. 

Fluidextractum  Belladonnas  Radicis. 
Fluidextract  of  Belladonna  Root. 

Average  dose,  1U  i.-o.o5  mil. 

Emplastrum  Belladonnas. 
Belladonna  Plaster. 

Contains  30%  of  extract  of  belladonna  leaves.  There 
is  also  a  10%  ointment  of  belladonna. 

Atropina. 
Atropine. 

Average  dose,  gr.  Tio-o.ooo5  Gm. 

Atropinas  Sulphas. 
Atropine  Sulphate. 

Usually  given  hypodermically,  being  very  soluble  in 
water.  Average  dose,  gr.  1^0-0.0005  Gm. 

Homatropinae  Hydrobromidum. 
Homatropine  Hydrobromide. 

An  alkaloid  obtained  by  the  condensation  of  atropine 
and  mandelic  acid,  resembling  atropine  in  action,  but 
being  less  toxic  and  the  symptoms  passing  off  more 
quickly.  It  is  used  as  a  mydriatic  and  anhydrotic. 

Average  dose,  gr.  1^0-0.0005  Gm. 


230  MATERIA   MEDICA    FOR   NURSES. 

Stramonium. 
Jamestown  Weed. 

The  leaves  and  seeds  of  Datura  stramonium ,  a  weed 
of  this  country  and  Great  Britain.  The  active  princi- 
ple is  an  alkaloid  named  daturine,  which  is  said  to  be 
a  combination  of  atropine  and  hyoscyamine. 

Physiological  Actions. 

Stramonium  resembles  belladonna  very  closely  in  its 
actions.  By  small  doses  the  pulse  rate  is  increased, 
arterial  tension  raised,  and  the  respiration  quickened. 
It  is  a  mydriatic,  and  has  some  power  to  relieve  pain. 
One  difference  between  them  is  that  stramonium  is 
more  depressing  to  the  bronchial  nerves. 

The  action  on  the  intestinal  muscular  fibre  is  the 
same  in  both;  small  doses  increasing,  and  large  ones 
diminishing,  peristalsis.  By  large  doses  the  tension 
of  the  vessels  is  relaxed,  the  pulse  still  remaining 
frequent,  and  showing  a  tendency  to  intermit. 

Symptoms  of  Poisoning. 

The  symptoms  of  poisoning  are  much  alike — dilated 
pupils,  heightened  temperature,  rapid  pulse,  scarlet 
rash,  restlessness,  delirium,  and  convulsions,  with  the 
fatal  termination  preceded  by  stupor,  paralysis,  and 
asphyxia.  The  pulse  in  stramonium  poisoning  is 
much  more  inclined  to  irregularity  than  in  atropine 
poisoning.  The  treatment  is  the  same.  Accidental 
cases  are  common  among  children. 

Preparations  of  Stramonium. 

Extractum  Stramonii  (Powdered). 
Extract  of  Stramonium. 

Average  dose,  gr.  |-o.oi  Gm. 
Unguentum  Stramonii. 
Stramonium  Ointment. 

Strength,  10%. 


THE  VEGETABLE  KINGDOM.  231 

Tinctura  Stramonii. 
Tincture  of  Stramonium. 

Strength,  10%.    Average  dose,  "fT[  viii.-o.5  mil. 

Hyoscyamus,  Henbane. 

The  leaves  of  the  second  year's  growth  of  Hyoscya- 
mus niger,  a  coarse  plant  native  in  Great  Britain  and 
naturalized  in  the  United  States.  The  active  princi- 
ples are  two  in  number — hyoscyamine,  a  crystalline, 
and  hyoscine,  an  amorphous,  alkaloid.  These  princi- 
ples have  the  same  chemical  formula  as  atropine,  yet 
are  not  identical  with  it. 

Physiological  Actions. 

Hyoscyamus  is  a  mydriatic,  and  has  very  much  the 
same  physiological  actions  as  belladonna  and  stra- 
monium. It  has  greater  calmative  and  hypnotic 
powers  than  either  of  the  others,  due,  it  is  stated,  to 
its  hyoscine,  which  is  supposed  to  be  much  stronger 
than  hyoscyamine,  and  to  have  marked  qualities  as 
a  cerebral  sedative. 

Like  the  former  two  drugs,  it  is  a  cardiac  and 
respiratory  stimulant,  the  pulse  under  its  influence 
being  more  regular  than  the  pulse  of  daturine.  It  has 
the  same  stimulant  action  on  the  muscular  fibres  of  the 
intestines,  thus  being  somewhat  laxative.  In  poison- 
ing, the  dry  mouth,  flushed  face,  dilated  pupils,  and 
busy  delirium  are  the  same  as  with  belladonna  and 
stramonium,  and  the  treatment  is  the  same.  Hyo- 
scyamine is  rapidly  excreted  by  the  urine. 

Preparations  of  Hyoscyamus. 

Tinctura  Hyoscyami. 
Tincture  of  Hyoscyamus. 

Made  in  a  strength  of  10%.     Average  dose,  n 
mils. 


232  MATERIA  MEDICA  FOR  NURSES. 

Fluidextractum  Hyoscyami. 
Fluidextract  of  Hyoscyamus. 

Average  dose,  ni  iii.-o.2  mil. 

Hyoscyaminse  Hydrobromidum. 
Hyoscyamine  Hydrobromide. 

Average  dose,  gr.  5^0-0.0003  Gm. 

Scopolaminae  Hydrobromidum. 
Scopolamine,  or  Hyoscine  Hydrobromide. 

Hyoscine  is  a  powerful  hypnotic,  and  differs  from 
atropine  in  reducing  the  pulse  rate.  This  is  the  first 
evidence  of  its  action,  and  is  shown  in  a  few  moments. 
The  fall  may  be  from  8  to  20  beats  in  a  moment,  and 
this  effect  is  the  last  to  disappear.  Hyoscine  does  not 
always  dilate  the  pupils.  It  is  eliminated  by  the  urine. 

Average  dose,  gr.  ^0-0.0003  Gm. 

Capsicum,  Cayenne  Pepper. 

The  fruit  of  Capsicum  frutescens,  the  African  pep- 
per. The  active  principle  is  a  very  acrid  oleoresin 
which  is  powerfully  irritant,  being  capable  of  destroy- 
ing the  skin  if  applied  to  it.  Capsicum  is  a  stimulant 
stomachic,  giving,  in  moderate  doses,  a  pleasant  feel- 
ing of  warmth.  In  overdose  it  may  cause  severe  pain 
and  inflammation,  with  vomiting  and  purging.  It  is 
useful  as  a  corrective  in  flatulence  and  slight  diarrhoea. 

Preparations. 

Tinctura  Capsici. 
Tincture  of  Capsicum. 

Strength,  10%.     Average  dose,  m  viii.-o.5  mil. 

Emplastrum  Capsici. 
Capsicum  Plaster. 


THE    VEGETABLE  KINGDOM.  233 

Tabacum  (Tobacco).    Not  official. 

The  leaves  of  Nicotiana  tabacum,  a  native  of  tropi- 
cal countries  cultivated  in  the  North. 

They  contain  an  exceedingly  powerful  alkaloid, 
nicotine;  a  volatile  oil,  nicotiana;  and,  in  slight  propor- 
tions, the  folfjwing  alkaloids,  some  of  which  are 
familiar  as  being  found  in  other  plants:  lupuline, 
coniine,  lobeline,  piperidine,  muscarine,  and  sparteine; 
also  the  alkaloidal  compound  trimethyamine. 

Tobacco  smoke  contains  but  little  nicotine,  if  any, 
and  a  large  proportion  of  pyridine. 

Nicotine  is  one  of  the  most  violent  poisons  known, 
acting  almost  as  rapidly  as  prussic  acid. 

Death  has  followed  a  toxic  dose  in  three  minutes. 
Emetics,  tannin,  and  artificial  respiration  are  to  be 
employed  in  treating  the  poisoning.  Tobacco  is  no 
longer  used  in  medicine,  being  seriously  depressing  in 
its  effects. 

Fam.  Scrophidariacete. 
Digitalis,  Foxglove. 

The  well  dried  leaves  of  Digitalis  purpurea>  native 
of  Great  Britain,  and  cultivated  in  this  country. 

The  active  principle,  digitalin,  is  one  of  several 
important  and  complex  principles  of  difficult  analysis. 
Digitalin  is  no  longer  official,  the  preparations  made 
from  the  whole  leaf  being  considered  more  trust- 
worthy. 

Physiological  Actions. 

The  most  important  action  of  digitalis  is  as  a  heart 
stimulant  and  tonic,  and  is  shown  in  the  slowing  and 
strengthening  of  the  pulse.  This  is  partly  brought 
about  by  a  direct  action  on  the  heart-muscle,  by  which 
the  circulation  in  the  organ  itself  is  more  efficiently 
carried  on;  partly  by  a  strengthening  of  the  inhibitory 


234  MATERIA   MEDIC  A    FOR  NURSES. 

apparatus,  which  tends  to  slow  the  heart;  and  partly 
by  a  stimulant  action  on  the  vaso-motor  system,  by 
which  the  arteries  are  more  strongly  contracted,  and, 
by  offering  some  resistance  to  the  force  of  the  heart, 
excite  it  to  greater  effort.  The  result  of  all  this  is,  that 
the  diastole  is  lengthened,  and  the  systole  becomes 
more  energetic.  Thus  the  ventricles  are  better  filled 
and  more  thoroughly  emptied,  and  the  beats,  reduced 
in  number,  gain  in  firmness  and  strength. 

When  an  excessible  amount  is  taken,  signs  of  over- 
stimulation  appear,  marked  by  intermittency  of  the 
pulse  or  by  a  fall  below  normal;  it  may  be  to  40  or  50 
in  a  minute.  In  this  condition  any  sudden  exertion, 
such  as  sitting  upright,  may  bring  to  a  climax  the 
growing  exhaustion  of  the  heart,  and  the  pulse  may 
run  up  to  150  or  more,  becoming  small,  weak,  and 
irregular.  For  this  reason  patients  taking  digitalis 
continuously  must  be  kept  quietly  in  bed  and  not 
allowed  to  sit  up  or  to  make  any  sudden  exertion. 

In  taking  it  only  occasionally  or  for  a  short  time 
there  is  not  the  same  danger. 

Digitalis  is  also  a  diuretic,  acting  through  an  in- 
fluence on  the  renal  as  well  as  on  the  general  circula- 
tion, and  for  this  purpose  it  is  also  used  locally  in  the 
form  of  poultices  applied  over  the  kidneys,  and  made 
from  the  leaves  or  with  the  fluid  preparations.  Digi- 
talis is  eliminated  by  the  urine,  and  much  more  slowly 
than  it  is  absorbed  into  the  system.  For  this  reason, 
if  doses  are  given  close  together,  part  of  the  influence 
of  one  may  be  added  to  that  of  the  next,  and  the  action 
is  intensified  by  so  much.  But  except  conditionally 
in  this  way,  a  cumulative  action  of  the  drug  is  not 
acknowledged  by  all  authorities. 

Symptoms  of  Poisoning. 

In  cases  of  poisoning  the  symptoms  begin  with  vio- 
lent and  repeated  vomiting  of  mucus  and  bile.  There 
is  a  feeling  of  vertigo,  pain,  and  heat  in  the  head,  and 
disturbance  of  vision,  fringes  of  color  with  a  vibratory 
motion  being  sometimes  seen  around  objects. 


THE    VEGETABLE  KINGDOM.  235 

The  face  is  pale,  the  eyes  staring  and  prominent, 
with  dilated  pupils  and  a  blue  color  of  the  sclerotics. 

There  is  sometimes  salivation,  and  usually  diarrhoea. 
The  urine  may  be  suppressed.  The  vomiting  con- 
tinues, and  great  prostration  follows.  The  pulse  is 
irregular,  small,  and  weak,  yet  the  beat  of  the  heart 
may  be  hard  and  strong.  The  respirations  become 
rapid  and  feeble.  Pains  in  the  limbs  and  back  may 
be  present.  There  are,  usually  before  the  end,  de- 
lirium and  stupor,  or  convulsions.  Death  occurs 
from  general  failure  of  the  circulation  with  final 
paralysis  of  the  heart,  and  has  taken  place  as  soon 
as  three  quarters  of  an  hour  after  taking  the  poison. 
The  average  time,  however,  is  one  or  two  days. 
Digitalis  poisoning  of  an  acute  form  is  not  common, 
and  in  the  majority  of  cases  the  patient  recovers. 
The  smallest  fatal  dose  is  not  known.  Twenty  grains 
of  the  extract  are  known  to  have  caused  death  in  ten 
days. 

Treatment  of  Poisoning. 

Kmetics  and  cathartics  must  be  given,  and  tannin  in 
large  quantities.  Alcoholic  stimulants  are  used,  but 
with  great  care,  and  the  most  perfect  rest  and  quiet, 
with  a  perfectly  horizontal  position,  maintained. 

Incidental  Effects.  % 

Digitalis  is  very  bitter,  nauseating,  and  irritant  to 
the  stomach,  and  is  apt  to  interfere  with  digestion,  and 
to  cause  vomiting,  with  occasional  diarrhoea,  marked 
by  green  discharges.  These  two  latter  symptoms  may 
also  be  produced  by  hypodermic  administration  of  the 
drug. 

Headache  and  vertigo,  fainting,  sneezing,  and  buz- 
zing in  the  ears,  are  caused  by  overdoses;  also  sparks 
before  the  eyes  and  other  disturbances  of  sight;  sleep- 
lessness; fall  of  temperature;  and  irregularity  or 
threadiness  of  the  pulse. 


236  MA  TERIA  MEDICA  FOR  NURSES. 

Recent  experiments  prove  that  digitalis  does  not  in- 
crease the  strength  or  force  of  the  heart's  beats,  but 
simply  the  extent  of  the  contraction  is  increased.  The 
heart  cavity  is  more  nearly  closed  and  the  contrac- 
tion of  the  heart- muscle  is  more  nearly  complete  than 
is  normally  the  case. 

Hypodermic  injections  of  digitalis  or  of  strychnine 
act  in  case  of  shock  by  a  redistribution  of  the  blood 
in  different  parts  of  the  body,  thus  restoring  func- 
tion. Digitalin  has  been  used  in  cases  where  digi- 
talis cannot  be  taken  by  mouth.  Dose,  -jVSV  gr- 
American  digitaline,  or  <&-$  gr.  Merck's  German 
digitaline,  injected  deep  into  the  muscles  of  the  thigh, 
which  are  then  to  be  rubbed  thoroughly  for  at  least 
five  minutes  to  hasten  absorption  and  prevent  abscess 
formation. 


Preparations  of  Digitalis. 

Infusum  Digitalis. 
Infusion  of  Digitalis. 

More  diuretic  than  stimulant.     To  be  largely  diluted. 
Average  dose,  3  i-~4  mils. 

Tinctura  Digitalis. 
Tincture  of  Digitalis. 

Strength,  10%.     Average  dose,  Til  viii.-o.5  mil. 

Fluidextractum  Digitalis. 
Fluidextract  of  Digitalis. 

The  tincture  and  fluidextract  are  more  stimulant 
than  diuretic,  and  are  only  slightly  diluted  when  given. 

The  variability  of  different  preparations  of  digitalis, 
resulting  in  disappointing  or  in  injurious  action  when 
prescribed  in  medicine,  has  caused  the  narrowing  down 
to  the  now  brief  list  of  official  preparations  of  the 
drug. 


THE  VEGETABLE  KINGDOM.       237 

Digitalin  was  formerly  recognized  by  the  U.  S.  P. 
It  has  been  used  hypodermically,  but  was  found  to  be 
irritating  and  liable  to  cause  abscesses.  This,  with 
the  uncertainty  of  exact  composition  brought  it  into 
disfavor,  and  artificial  preparations  are  equally  un- 
satisfactory. 

Fam.  Labiate. 

Oleum  Lavandulae,  Oil  of  Lavender, 
Oil  of  Lavender  Flowers. 

An  oil  obtained  from  the  flowers  of  Lavandula 
officinalis. 

Tinctura  Lavandulae  Composita. 
Compound  Tincture  of  Lavender. 

May  be  pleasantly  used,  in  small  quantity,  added  to 
water  for  bathing. 

Spiritus  Lavandulae. 
Spirits  of  Lavender. 

A  stomachic  and  cordial.  Average  dose,  3  ss.-2 
mils. 

Oleum  Mentha  Piperitse,  Oil  of  Peppermint. 

The  oil  of  the  fresh  flowering  peppermint. 

Aqua  Menthae  Piperitae. 
Peppermint  Water. 

Used  as  a  carminative.  Average  dose,  3  iv.-i5 
mils  in  water. 

Menthol. 

(Peppermint  Camphor.) 

A  secondary  alcohol  obtained  from  peppermint  oil  or 
other  mint  oils.  Used  as  a  local  anaesthetic  in  head- 
ache, in  the  form  of  a  pencil.  It  is  also  given  internally 
as  a  carminative. 

Average  dose,  gr.  i.-o.o6  Gm. 


238  MATERIA    MEDICA    FOR  NURSES. 

Thymol. 

A  phenol  occurring  in  the  volatile  oils  of  Thymus 
vulgaris  and  other  herbs.  It  is  an  antiseptic  and  ger- 
micide resembling  carbolic  acid  and  oil  of  turpentine  in 
action. 

Average  dose,  antiseptic,  gr.  ii.-o.i25  Gm. 

Average  dose,  anthelmintic,  gr.  xv.-i  Gm.  per  day. 

Fam.  Polygonacea* 
Rheum,  Rhubarb. 

The  root  of  Rheum  offitinale,  from  China. 

Rhubarb  contains  cathartic  acid,  a  peculiar  tannic 
acid,  a  yellow  coloring  matter,  etc. 

Rhubarb  acts  entirely  on  the  alimentary  canal.  In 
small  doses  it  is  stomachic,  strengthening  appetite 
and  digestion.  In  large  doses  it  is  a  cathartic,  with 
astringent  after-effects. 

In  its  purgative  action  the  liver  is  stimulated  as  well 
as  the  intestinal  glands,  and  evacuation  takes  place  in 
six  or  eight  hours,  accompanied  by  some  griping  pain. 

Preparations  of  Rhubarb. 

Fluidextractum  Rhei. 
Fluidextract  of  Rhubarb. 

Average  dose,  TT[  xv.-i  mil.  ft 

Syrupus  Rhei. 
Syrup  of  Rhubarb. 

Average  dose,  3  iiss.-io  mils. 

Tinctura  Rhei. 
Tincture  of  Rhubarb. 
Average  dose,  3  i.~4  mils. 

Fam.  Lauracecz. 

Camphora,  Camphor. 

Obtained  from  the  wood  of  Cinnamomum  Camphora, 
of  China  and  other  Eastern  countries. 


THE    VEGETABLE  KINGDOM.  239 

Camphor  is  one  of  the  most  widely  diffused  of  all 
vegetable  substances.  It  is  found  in  pennyroyal, 
hemp-tops,  and  numbers  of  other  plants. 

Physiological  Actions. 

Externally  applied,  camphor  is  irritant,  stimulat- 
ing the  local  circulation.  It  has  feeble  antiseptic 
power,  and  is  sedative  to  the  nerves  after  first  stimu- 
lating them.  Internally,  it  acts  as  a  carminative  and 
anti-spasmodic,  gives  increased  force  and  fulness  to 
the  pulse,  and  stimulates  the  cerebro-spinal  nerves. 
When  large  doses  (gr.  xx.-xxx.)  are  given,  the  pulse 
falls,  and  a  feeling  of  lassitude  and  giddiness  is 
produced. 

Symptoms  of  Poisoning. 

After  poisonous  doses  (gr.  xxx.-lx.),  there  are  faint- 
ness  and  headache,  vertigo,  confused  ideas,  burning 
pain  in  the  stomach,  delirium,  convulsions,  and  in- 
sensibility. The  pulse  is  small,  sometimes  slow,  again 
accelerated.  The  skin  is  pale,  cold,  and  covered  with 
perspiration.  No  death  of  an  adult  has  occurred  with 
camphor. 

Preparations. 

Aqua  Camphorae. 
Camphor  Water. 
Eight  Gm.  in  looomils.  Average  dose,  3  iiss.-io  mils. 

Spiritus  Camphors. 
Spirit  of  Camphor. 

Strength,  i  to  10.    Average  dose,  TT[  xv.-i  mil. 
Linimentum  Camphorae. 
Camphor  Liniment. 

Cotton-seed  oil,  8  parts;  camphor,  2  parts. 

Linimentum  Saponis. 
Soap  Liniment. 

Soap,  60  Gm.;  camphor,  45  Gm.;  alcohol,  oil  of  rose- 
mary, and  water  to  make  1000  mils. 


240  MATERIA   MEDICA   FOR  NURSES. 

Oleum  Camphorae. 

Oil  of  Camphor.    Not  official. 

More    stimulating    than    the    other    preparation 
Average  dose,  TT{,  v.-o.3  mil.x.)'     (0.3-0-65  Cc.) 

Cinnamomum  (Cinnamon). 

The  bark  of  different  varieties  of  the  genus  Cinna- 
mon. It  contains  tannic  acid  and  a  yellowish  volatile 
oil,  oleum  cinnamomi.  This  has  a  fragrant  and  pleas- 
ant taste,  and  is  used  to  mitigate  that  of  disagreeable 
drugs.  The  preparations  of  cinnamon  are  used  as 
carminatives. 

Pulvis  Aromaticus. 
Aromatic  Powder. 

Is  composed  of  cinnamon,  ginger,  cardamom,  and 
nutmeg.  It  is  given  in  an  average  dose  of  gr.  xv.-i  Gm. 

Fa m .  A  t  istolochiacea . 

Serpentaria,  Texas  or  Virginia  Snakeroot. 

The  dried  rhizome  and  rootlets  of  two  or  three  varie- 
ties of  Aristolochia,  found  in  North  America.  The 
taste  and  odor  resemble  camphor.  It  contains  a  resin, 
a  volatile  oil,  bitter  principle,  etc.,  and  is  a  stimulant 
tonic.  Its  only  official  use  is  in  the  compound  (Tr.  of 
Cinchona). 

Preparations. 

Tinctura  Serpentariae.     Not  official. 
Tincture  of  Serpentaria. 

Strength,  20%.     Dose,  3  i.~4  mils. 

Fluidextractum  Serpentariae.    Not  official. 
Fluidextract  of  Serpentaria. 

Dose,  TU  xv.-i  mil. 

To  be  given  half  an  hour  before  meals. 


THE    VEGETABLE  KINGDOM.  241 

Goto  Bark.    Not  official. 

The  bark  of  trees  found  in  South  America,  some- 
what similar  to  the  Cinchona,  having  an  aromatic 
resinous  odor  and  pungent  taste.  It  contains  a  bitter 
principle,  cotoin,  and  has  astringent  action.  It  is 
irritant  to  the  skin  and  mucous  membranes. 

Fluidextractum  Goto. 
Fluidextract  of  Goto  Bark. 

Average  dose,  TH,  viii.-o.5  mil. 

Should  be  given  in  wine  or  other  dilute  alcohol,  as 
it  does  not  combine  with  water,  but  forms  a  precipitate. 

Cotoin. 

Average  dose,  gr.  i.-o.o6  Gm. 

Paracotion,  active  principle  of  a  similar  bark,  is  given 
in  larger  dose. 

Fam.  Euphorbiacea. 
Oleum  Tiglii,  Croton  Oil. 

A  fixed  oil,  obtained  from  the  seeds  of  Croton 
Tiglium,  a  shrub  of  Asia.  The  oil  is  quite  thick  and 
becomes  more  so  with  age;  deteriorates  rapidly  in 
quality  and  should  not  be  kept  long,  but,  if  possible, 
always  obtained  fresh.  In  color  it  may  vary  from  a 
pale  yellow  to  a  dark  reddish-brown.  The  taste  is 
acid  and  hot. 

It  is  a  very  complex  substance,  containing  several 
fixed  oils  and  volatile  acids.  It  is  supposed  to  con- 
tain a  vesicating  principle  and  a  distinctly  purgative 
one,  but  the  latter  has  not  yet  been  obtained  separate 
from  the  others.  Croton  oil  is  soluble  in  alcohol. 

Physiological  Actions. 

It  is  a  very  powerful  irritant  and  vesicant  when 
externally  applied,  causing  burning  and  redness  of  the 
skin  and  an  eruption  of  papules,  which  in  a  short  time 
become  pustular.  Taken  internally  it  irritates  actively; 

16 


242  MATERIA    MEDIC  A   FOR  NURSES, 

causes  burning  in  the  throat  and  epigastrium,  and 
has  a  very  rapid  action  as  a  drastic  and  hydragogue 
cathartic. 

The  bowels  are  first  opened  in  one  or  two  hours  after 
it  is  taken,  and  catharsis  re-occurs  several  times  within 
twelve  hours  or  more,  with  great  thoroughness,  some 
pain,  and,  usually,  a  decided  degree  of  prostration. 

The  dose,  which  is  usually  one  or  two  drops — some- 
times three  or  four — may  be  given  on  bread-crumbs,  or 
in  a  little  glycerin,  or  on  a  lump  of  sugar. 

With  unconscious  or  delirious  patients  it  may  be 
placed  directly  on  the  back  of  the  tongue.  In  apply- 
ing it  externally,  the  amount  ordered  is  taken  on  a 
bit  of  flannel,  and  rubbed  into  the  prescribed  spot  on 
the  skin  until  there  is  well-marked  redness.  The 
eruption  appears  usually  in  about  four  hours;  if  it  does 
not,  the  application  is  repeated. 

It  may  also  be  mixed  .with  olive  oil  or  turpentine,  or 
combined  with  liniments,  alcohol,  or  ether. 

The  eruption  remains  for  several  days,  and  may,  oil 
disappearing,  leave  small  cicatrices  behind  it. 

Symptoms  of  Poisoning. 

Though  so  active  in  small  doses  there  have  not  been 
many  known  instances  of  fatal  poisoning  by  croton  oil. 
I^arge  doses  usually  provoke  immediate  vomiting,  but 
symptoms  when  developed  are  those  of  gastro-enteritis, 
with  violent  catharsis  and  great  prostration. 

In  some  instances,  instead  of  acting  in  the  usual  way 
it  seems  to  be  absorbed  into  the  blood,  and  produces 
nervous  symptoms,  such  as  palpitation  and  restless- 
ness, headache,  giddiness,  and  confusion  of  ideas. 

Oleum  Ricini,  Castor  Oil. 

The  oil  expressed  from  the  seeds  of  Ricinus  com- 
munis,  of  Calcutta.  Castor  oil  contains  several  fatty 
acids,  of  which  ricinoleic  acid  is  peculiar  to  itself. 


THE    VEGETABLE  KINGDOM.  243 

Physiological  Actions. 

Externally  castor  oil  is  very  soothing,  and  may  be 
applied  to  the  eye,  or  the  surface,  as  a  sedative  and 
protective  if  perfectly  pure. 

Internally  it  is  unirritating  to  the  stomach,  if  pure, 
but  if  impure  or  rancid  it  may  cause  nausea  and  vomit- 
ing. Aside  from  this,  the  odor  may  provoke  nausea 
even  before  the  drug  is  swallowed,  and  all  pains  should 
be  taken  to  avoid  this  possibility,  by  preparing  it  care- 
fully and  holding  it  at  the  side — not  under  the  patient's 
nose — until  the  moment  comes  for  swallowing  it. 

In  the  intestines  it  acts  as  a  simple  purgative,  and 
here  the  oil  which  is  not  perfectly  pure  is  more  efficient. 
It  is  painless,  with  sedative  and  somewhat  constipating 
after-effects. 

The  muscular  coat  and  the  glands  of  the  intestines 
are  stimulated,  and  evacuation  results  in  from  three  to 
six  hours — sometimes  sooner. 

It  is  not  a  hydragogue  cathartic,  as  it  does  not  ap- 
preciably increase  the  intestinal  secretions.  It  does 
not  act  on  the  liver. 

Ricinoleic  acid  enters  the  blood  and  tissues  and  is 
removed  by  all  secretions,  including  the  milk,  and  in 
this  way  purgation  may  be  produced  in  a  nursing 
infant. 

Castor  oil  is  very  nauseous,  and  needs  to  be  carefully 
administered,  in  order  that  it  may  be  as  little  offensive 
as  possible.  To  children  it  is  best  given  in  hot  sweet- 
ened milk,  and  adults  may  take  it  well  in  this  way;  or 
it  may  be  poured  into  the  centre  of  an  equal  quantity 
of  glycerin,  or  given  in  a  little  hot  coffee,  or  in  soda 
water,  or  in  brandy;  first  wetting  the  sides  of  the  glass, 
and  pouring  the  oil  carefully  in  the  centre  of  3  ss. 
brandy,  then  covering  it  with  as  much  more.  In  all 
cases  it  will  be  more  easily  taken  if  the  mouth  be  first 
rinsed  out  with  brandy  or  peppermint,  or  any  thing 
pungent  which  will  blunt  the  sense  of  taste.  A  little 
carbonated  water  afterwards  is  gratefully  received,  or, 
to  those  who  like  olives,  nothing  is  more  acceptable 


244  MATERIA  MEDICA  FOR  NURSES. 

after  nauseating  or  bitter  medicines  than  an  olive, 
when  it  may  be  given. 

Castor  oil  can  be  had  put  up  in  soft  flexible  capsules, 
which,  though  large,  are  easily  swallowed. 

Average  dose,   §  ss.-i5  mils. 

Dose  for  infant  one  year  old,  3  {.-4  mils. 

The  castor  bean  is  very  poisonous.  The  leaves  have 
been  used  as  a  poultice,  applied  to  the  breasts  to  increase 
tiie  flow  of  milk. 

Fam.  Salicacece. 

Salicinum,  Salicin. 

A  glucoside,  obtained  from  the  bark  of  various 
species  of  Salix  or  willow  tree,  and  from  Gaultheria 
procumbent  or  wintergreen. 

Salicin  is  a  bitter  tonic,  and  to  some  extent  an 
antipyretic  and  antiseptic.  Its  qualities  resemble, 
though  in  a  very  mild  degree,  those  of  salicylic  acid, 
which  is  derived  from  it.  Salicin  is  not  poisonous.  It 
is  very  insoluble,  and  is  given  dry  on  the  tongue  or  in 
capsules. 

Dose,  gr.  xv.-i  Gm. 

Oleum  Gaultheriae,  Oil  of  Gaultheria. 
Oil  of  Wintergreen. 

A  volatile  liquid  of  penetrating  odor,  found  in  nature 
in  the  wintergreen,  Gaultheria  procumbens,  called  the 
teaberry,  and  in  the  sweetbirch,  Betula  lenta.  It  is 
composed  chiefly  of  methyl  salicylate,  and  this  is  the 
official  form  in  which  these  oils  are  listed.  Methyl 
salicylate,  besides  being  distilled  from  the  plants,  may 
also  be  made  artificially,  and  its  label  must  now  indicate 
its  natural  or  synthetic  character.  The  artificial  oil  is 
now  largely  used  instead  of  the  natural  oil. 

The  physiological  actions  of  the  oil  of  gaultheria  are 
th&same  as  those  of  salicylic  acid. 

It  is  given  in  emulsion  or  capsules. 

Average  dose,  TTI  x.-o.65  mils. 


THE    VEGETABLE  KINGDOM.  245 

Fam.  Zingiberacea. 
Zingiber,  Ginger. 

The  dried  root-stock  of  Zingiber  officinale  of  the  East 
and  West  Indies.  The  active  principles  are  an  aromatic 
resin  and  a  volatile  oil.  Ginger  is  a  stimulant  and 
carminative,  and  is  given  for  colic  or  cramp.  The 
tincture  is  used  in  doses  of  from  3  ss.-i.-2-4  Gm.,  in 
hot  water;  the  fluid  extract,  TH,  v.-x. -0.3-0. 65  mil. 

Cardamom!  Semen,    Cardamom  Seed. 

The  dried  seeds  of  Elettaria  Cardamomum  contain  a 
fixed  and  also  a  volatile  aromatic  oil. 

Cardamom  is  a  pleasant  stomachic,  less  heating  and 
stimulating  than  others  of  its  class. 

The  tincture  is  given  in  doses  of  TTj,  xxx.-2  mils,  and 
is  also  used  as  an  ingredient  in  tonic  mixtures. 

Cannabis. 

Various  forms  of  hemp  are  sold  and  used  in  the  East 
as  narcotic  stimulants.  The  dried  plant  is  sold  in 
Calcutta  for  smoking,  and  is  called  Gunjah.  Churrus 
is  the  resinous  exudation  with  scrapings  of  the  leaves, 
and  Hashish  is  an  Arabian  preparation.  The  U.S.  P. 
now  recognizes  the  dried  flowering  tops  of  two  varieties 
of  the  plant,  cannabis  sativa  and  indica. 

Physiological  Actions. 

Cannabis  indica  in  full  doses  causes  a  mental  state  of 
joyous  exhilaration.  The  subject  may  fall  into  a 
revery,  while  beautiful  visions  pass  before  the  eyes,  or 
he  may  laugh  loudly  and  give  other  manifestations  of 
being  in  an  ecstatic  state.  The  pupils  dilate  and  the 
pulse-rate  rises.  Partial  anaesthesia,  local  spasms,  and 
convulsions  may  be  noticed.  After  the  first  stage  tfce 
subject  falls  into  a  heavy  sleep.  The  Hindoos  are  said 
to  induce  a  state  of  catalepsy  by  the  use  of  hemp. 


246  MATERIA   MEDICA   FOR  NURSES. 

It  is  not  an  acute  poison,  and  does  not  endanger  life, 
even  when  the  symptoms  produced  by  it  are  of  an 
alarming  character.  There  are  not  the  unpleasant 
after-effects  of  opium.  The  stomach  is  not  affected, 
nor  is  there  constipation.  The  urine,  rather  than 
decreasing,  is  increased  by  this  drug. 

It  has  been  used  to  some  extent  in  the  treatment  of 
insanity,  and,  aside  from  that,  for  the  relief  of  pain  and 
as  a  hypnotic.  Various  quack  medicines  advertised  as 
"  pain  killers  "  contain  cannabis. 

The  action  of  the  different  preparations  is  variable, 
and  it  is  supposed  that  much  of  the  supply  loses  its 
strength  during  the  ocean  voyage,  and  becomes  inert. 

Preparations. 

Tinctura  Cannabis. 
Tincture  of  Cannabis. 

Strength,  10%.     Average  dose,  TH,  xii.-o.ys  mil. 

Fluidextractum  Cannabis, 
Fluidextract  of  Cannabis. 

Average  dose,  TTJ,  iss.-o.  i  mil. 

Fam.  Moracea. 
Humulus,  Hops. 

The  dried  strobiles1  of  Humulus  Lupulus,  or  hop 
vine,  cultivated  in  Kngland.  They  contain  an  aromatic 
volatile  oil,  resins,  an  acid,  and  an  alkaloid  called 
lupuline. 

The  former  gives  a  stimulant  action,  with  after- 
effects that  are  sedative  and  sleep-producing.  The 
latter  gives  stomachic  and  tonic  qualities.  Hops  are 
also  slightly  astringent.  These  various  character- 
istics are  shown  in  ales  and  beers,  which  are  made 
from  hops.  The  heart  action  is  somewhat  strengthened 
and  quickened  by  hops,  and  diaphoresis  produced. 

1  Cones;  from  the  Latin  word  meaning  a  pine  cone. 


THE  VEGETABLE  KINGDOM.        247 

Hops  are  used  externally  for  the  relief  of  pain,  either 
as  a  means  of  applying  moist  heat,  when  they  are  put 
into  bags  and  wrung  out  of  hot  water;  or  as  dry  heat 
when — also  in  bags — they  are  heated  through.     Hop 
pillows  may  be  used  as  a  means  of  inducing  sleep.    The 
crackling  of  the  hops,  which  may  annoy,  can  be  stopped 
by  sprinkling  them  with  alcohol. 
Lupulinum.     Not  official. 
Lupulin. 

Average  dose,  gr.  vi.-o.oi  Gm. 

Fluidextractum  Lupulini.     Not  official. 
Fluidextract  of  Lupulin. 

Average  dose,  TH,  viii.-o.5  mil. 

Nat.  Ord.  Conifers. 
Fix  Liquida,  Tar,  Pine  Tar. 

Tar  is  a  product  obtained  by  the  destructive  dis- 
tillation of  the  wood  of  several  varieties  of  pine.  It 
contains  pyroligneous  acid,  methylic  alcohol,  acetic 
acid,  creosote,  and  several  hydrocarbons,  one  of  which 
is  called  toluene,  also  oil  of  tar,  with  other  oily  bodies, 
and  pyrocatechin. 

The  rectified  oil,  oleum  picis  liquidse  rectificatum,  is 
used  locally  and  by  inhalation.  It  contains  a  large 
number  of  compounds,  among  which  are  creosote  and 
carbolic  acid. 

Tar  ointment  has  50%  of  tar.  The  syrup  of  tar  has 
5  Gm.  in  1000  mils.  Average  dose,  3  i.~4  mils. 

Oleum  Terebinthinae,  Oil  of  Turpentine. 

The  oil  distilled  from  turpentine,  which  is  obtained 
from  several  varieties  of  pines,  chiefly  those  growing 
in  the  South.  Called  also  "  Spirits  of  Turpentine." 

Turpentine,  as  such,  is  not  used  in  medicine.  It 
may  be  separated  into  the  oil  and  a  resin,  which,  com- 
bined with  lead  plaster,  forms  adhesive  plaster. 


248  MATERIA  MEDICA   FOR  NURSES. 

Physiological  Actions. 

Externally  oil  of  turpentine  is  stimulating  and  very 
irritant,  causing  redness  and  heat  followed  by  vesica- 
tion.  Its  action  as  a  counter-irritant  needs  to  be 
watched  with  much  care,  as  severe  blistering,  with 
depression  of  the  general  system,  may  result  if  its 
applications  be  too  long  continued.  Turpentine  is 
absorbed  by  the  whole  skin,  and  enters  the  blood 
unchanged. 

Internally  in  moderate  doses  its  immediate  action  is 
slightly  antiseptic  and  stimulant  to  the  blood-vessels. 
On  the  nerves  it  acts  locally  as  a  sedative,  and  in  the 
intestines  stimulates  the  muscular  coat,  and  is,  in 
larger  doses,  a  purgative. 

It  is  a  carminative,  expelling  gas  from  the  intes- 
tines, and  this  result  is  produced  as  well  by  outward 
applications  and  by  enemata  as  when  given  by  mouth. 
It  is  also  an  anthelmintic,  and  is  given  in  enemata  for 
thread-worm. 

It  is  a  stimulant  diuretic,  producing  in  large  doses 
active  irritation  or  congestion  of  the  urinary  organs, 
with  pain,  or  it  may  be  strangury  or  hsematuria.  The 
strength  and  rapidity  of  the  pulse  are  increased  by 
turpentine. 

In  large  doses  it  has  a  sedative  effect  on  the  brain 
and  spinal  cord,  shown  by  heaviness  and  drowsiness, 
an  unsteady  gait,  and  debility.  The  temperature  is 
lowered  slightly.  It  is  eliminated  by  the  kidneys  and 
lungs,  giving  its  own  odor  to  the  breath,  and  the  odor 
of  violets  to  the  urine. 

Turpentine  is  capable  of  causing  death,  but  fatal 
cases  are  very  rare,  and  there  are  but  few  instances 
even  of  serious  poisoning. 

Symptoms  of  Poisoning. 

The  symptoms  recorded  in  such  cases  include 
usually  vomiting  and  purging,  though  they  do  not 
always  exist.  The  pupils  are  dilated;  the  pulse  rapid, 
weak,  and  irregular.  The  skin  may  be  either  dry  or 


THE    VEGETABLE  KINGDOM.  249 

moist;  the  urine  diminished  or  suppressed  altogether, 
or  containing  blood.  In  most  cases  unconsciousness 
is  complete. 

Death  in  one  instance  was  supposed  to  have  followed 
a  dose  of  §  vi.,  but  recovery  has  taken  place  in  other 
cases  after  doses  nearly  as  large. 

Oleum  Terebinthinae  Rectificatum. 
Rectified  Oil  of  Turpentine. 

Average  dose,  "HI  V.-O.3  mil. 

It  may  be  given  on  a  lump  of  sugar.    Turpentine 
liniment  is  made  of  oil  of  turpentine  and  rosin  cerate. 
Sanitas.     Not  official. 

A  disinfectant  fluid,  put  up  for  use  in  sick-rooms. 
It  is  made  with  oxydized  turpentine,  and  contains 
peroxide  of  hydrogen  as  active  principle.  It  does  not 
stain  clothing. 

Oleum  Juniperi,  Oil  of  Juniper. 

A  volatile  oil  from  the  ripe  fruit  of  Juniperus  corn- 
munis. 

Juniper  resembles  turpentine  in  many  of  its  actions, 
but  it  is  less  powerful  and  also  less  disagreeable.  It  is 
a  stomachic  stimulant  and  diuretic.  In  large  doses 
it  inflames  the  kidneys  and  produces  strangury. 

Average  dose,  TTJ,  iii.-o.2  mil. 

Other  Vegetable  Oils. 

The  U.  S.  P.  gives  a  long  list  of  volatile  and  aroma- 
tic or  fixed  oils  of  vegetable  origin;  among  them  are: 
Oil  of  Anise,  Oleum  Anisi;  Oil  of  Orange,  Oleum  Aur- 
antii;  Oil  of  Caraway,  Oleum  Cari;  Oil  of  American 
Wormseed,  Oleum  Chenopodii;  Oil  of  Coriander,  Oleum 
Coriandri;  Oil  of  Fennel,  Oleum  Foeniculi;  Oil  of 
Lemon,  Oleum  Limonis;  Oil  of  Nutmeg,  Oleum  Myris- 
ticse;  Oil  of  Allspice  or  Pinienta,  Oleum  Pimentae;  Oil 
of  Rosemary,  Oleum  Rosmarini;  and  Oil  of  Sassafras, 
Oleum  Sassafras.  All  these  mentioned  are  given  in  an 
average  dose  of  TTi  iii.-o.2  mil,  showing  their  potent 
and  concentrated  qualities. 


2$0  MATERIA  MEDICA  FOR  NURSES. 

Fam.  Liliacete. 
Scilla,  Squill. 

Part  of  the  bulb  of  Urginea  maritima,  a  plant  01 
Southern  Europe. 

Squill  increases  the  strength  and  reduces  the  fre- 
quency of  the  heart  action;  contracts  the  arterial 
system  and  raises  blood  pressure.  It  is  diuretic  by 
means  of  its  action  on  the  circulation  in  the  kidneys, 
and  a  stimulant  expectorant,  increasing  the  bron- 
chial secretion  by  improving  the  local  circulation  and 
aiding  in  the  expulsion  of  the  mucus. 

In  overdoses  it  is  irritant,  and  may  cause  inflam- 
mation of  the  kidneys,  with  strangury  and  bloody 
urine,  or  suppression.  It  is  also  irritant  to  the  stomach 
and  intestines,  and  even  in  medicinal  doses  may  dis- 
order digestion.  Full  doses  cause  nausea,  vomiting, 
and  diarrhoea. 

Symptoms  of  Poisoning. 

Fatal  poisoning  has  been  caused  by  squill,  in  which 
these  symptoms  were  present  in  an  aggravated  form, 
with  marked  depression  of  the  pulse,  convulsions,  and 
collapse.  Death  has  resulted  from  a  dose  of  24  grains. 

Treatment  of  Poisoning. 

The  stomach  and  bowels  must  be  emptied  by  ipecac 
and  castor  oil.  Large  quantites  of  water  should  be 
given  to  overcome  the  suppression  of  urine,  and  the 
usual  methods  of  treating  gastro-enteritis  and  collapse 
employed. 

Preparations. 

Tinctura  Scillae. 
Tincture  of  Squill. 

Strength  10%.     Average  dose,  TTJ,  xv.-i  mil. 


THE  VEGETABLE  KINGDOM.        2$l 

Fluidextractum  Scillae. 
Fluidextract  of  Squill. 

Average  dose,  Tl[  iss.-o.i  mil. 

Syrupus  Scillae. 
Syrup  of  Squill. 

Average  dose,  TH,  xxx.-2  mils. 

Syrupus  Scillae  Compositus. 
Compound  Syrup  of  Squill. 

Contains  squill,  senega,  and  tartar  emetic.  Average 
dose,  TT[  xxx.-2  mils. 

Sarsaparilla,  Sarsaparilla. 

The  varieties  of  Sarsaparilla  used  in  medicine  are 
obtained  from  the  dried  root  of  Smilax  offidnalis  and 
other  varieties  of  smilax.  The  drug  contains  three 
glucosides:  parillin,  saponin,  and  sarsaponin. 

Sarsaparilla  is  widely  used,  yet  no  definite  physio- 
logical actions  can  be  claimed  for  it.  Whatever  value 
it  may  have  is  as  an  alterative.  The  syrup  is  some- 
times used  to  disguise  the  taste  of  potassium  iodide. 

Preparations. 

Syrupus  Sarsaparillae  Compositus. 
Compound  Syrup  of  Sarsaparilla. 

Contains  Sarsaparilla,   liquorice  root,  senna,  oil  of 
sassafras,  oil  of  anise,  and  oil  of  gaultheria. 
Average  dose,   §  ss.-i5  mils. 

Fluidextractum  Sarsaparillae  Compositum. 
Compound  Fluidextract  of  Sarsaparilla. 

Contains  Sarsaparilla,  liquorice  root,  sassafras,  and 
mezereum. 
Average  dose,  TH,  xxx.-2  mils. 


252  MATERIA  MEDICA  FOR  NURSES. 

Aloe. 
Aloes. 

The  thickened  juice  of  the  leaves  of  different  aloes 
from  an  island  in  the  Indian  Ocean,  and  Arabia.  It 
has  a  very  nauseous  and  bitter  taste,  and  contains  an 
active  principle,  aloin,  which  has  cathartic  qualities. 

Aloes  is  a  bitter  stomachic,  and  as  a  cathartic  acts 
principally  on  the  colon,  and  with  extreme  slowness, 
ten  or  fifteen  hours  being  required  for  a  result  if  it  is 
given  alone.  It  stimulates  the  flow  of  bile  to  some 
extent,  and  excites  the  circulation  of  all  the  pelvic 
organs.  Aloes  is  rarely  used  alone,  but  is  an  ingredi- 
ent of  many  well-known  laxative  preparations  in 
liquid  and  in  pill  form,  usually  in  strength  of  2  or  3 
grains.  It  does  not  cause  constipation  as  an  after- 
effect, but,  on  the  contrary,  makes  the  intestines  more 
sensitive. 

Tinctura  Aloes. 
Tincture  of  Aloes. 

Strength,  10%.     Average  dose,  TTl  xxx.-2  mils. 
Tinctura  Aloes  et  Myrrhae.    Not  official. 
Tincture  of  Aloes  and  Myrrh. 

Strength,  io%ofeach.     Average  dose,  3  ss.-2  mils. 
Pilulae  Aloes. 
Pills  of  Aloes. 

Average  dose,  2  pills. 

Fam.  Liliaceee. 
Convallaria  (Lily  of  the  Valley).    Not  official. 

The  rhizome  and  roots  of  the  Convallaria  majalis,  the 
lily  of  the  valley.  It  contains  two  glucosides:  one, 
convallarin,  is  crystalline,  and  has  special  qualities  as 
a  gastro-intestinal  irritant;  and  the  other,  conval- 
lamarin,  is  amorphous,  and  acts  as  a  stimulant  to  the 
circulation 


THE    VEGETABLE  KINGDOM.  253 

Physiological  Actions. 

Convallaria  slows  and  strengthens  the  heart,  and 
raises  the  blood  pressure;  makes  the  respirations  a 
little  more  full  and  less  frequent  than  ordinary,  and  is 
a  very  decided  diuretic.  In  excessive  doses  the  heart 
is  disturbed  and  the  pulse  becomes  irregular;  the 
breathing  is  forced,  deep  and  prolonged  inspiration 
being  produced  by  spasm  of  the  inspiratory  muscles. 

When  a  poisonous  quantity  is  taken,  arterial  pres- 
sure rises  very  high,  and  the  pulse  is  correspondingly 
rapid,  until  shortly  before  death,  when  the  pressure 
falls,  respiration  grows  slow  and  deep,  and  the  heart 
stops  in  systole.  Convallaria  does  not  affect  the  brain. 

Preparations. 

Fluidextractum  Convallariae.     Not  official. 
Fluidextract  of  Convallaria. 

Average  dose,  "H[  viii.-o.5  mil. 

Convallamarinum.     Not  official. 
Convallamarin. 

Average  dose,  gr.  ss.-o.c-3  Gm. 

Fam.  Phytolaccacecz . 
Phytolacca  (Poke).    Not  official. 

The  root  of  Phytolacca  decandra.  Phytolacca  is  de- 
pressing to  the  heart  and  respirations,  and  is  to  some 
extent  narcotic.  It  is  an  alterative,  and  promotes 
absorption  of  fatty  tissue.  "Anti-fat"  remedies  some- 
times contain  phytolacca.  It  is  useful  as  a  local  medica- 
ment, and  is  used  in  various  skin  disorders. 

Average  dose  of  the  fluid  extract,  alterative,  TH,  iss.- 
0.1  mil. 


254  MATERIA   MEDICA    FOR   NURSES. 

Fam.  Liliacea. 
Veratrum  Viride,  American  Hellebore. 

The  dried  rhizome  and  roots  of  Veratrum  viride,  a 
plant  belonging  to  the  Northern  States  of  the  United 
States. 

Physiological  Actions. 

Veratrum  viride  is  a  powerful  cardiac  depressant. 
When  taken  in  small  doses  the  pulse  is  at  first  reduced 
in  strength  and  later  in  frequency,  being  sometimes 
lowered  to  35  or  40  a  minute.  The  fall  of  the  pulse  is 
in  constant  proportion  to  dose  taken.  It  is  then  soft, 
compressible,  and  may  be  moderately  full,  but  any 
exertion  may  change  its  character  and  it  becomes 
rapid,  thready,  small,  and  weak,  being  at  times  almost 
imperceptible.  Nausea  and  vomiting  may  also  be 
produced  at  this  stage,  with  excessive  muscular  de- 
pression and  weakness.  The  depressing  action  on  the 
heart  is  the  result  of  direct  influence  over  the  heart 
muscle  and  also  over  the  inhibitory  apparatus.  The 
brain  is  not  affected. 

Symptoms  of  Poisoning. 

Excessive  doses  of  veratrum  viride  produce  violent 
and  alarming  symptoms,  but  fatal  results  from  it  are 
rare,  as  vomiting  is  usually  set  up  immediately.  The 
nausea  is  intense  and  the  emesis  violent,  the  skin  cold 
and  clammy,  and  the  pulse  thread-like. 

Hiccough,  faintness,  and  vertigo,  partial  uncon- 
sciousness, and  loss  of  sight  may  be  noticed  among 
the  symptoms  of  poisoning.  Recovery  has  taken  place 
after  a  teaspoonful  dose  of  the  fluid  extract,  and,  in 
another  case,  the  same  amount  caused  death. 

Treatment  of  Poisoning. 

Emesis  must  be  encouraged,  and  the  stomach  well 
washed  out  with  warm  water.  The  patient  should  not 


THE    VEGETABLE  KINGDOM.  255 

be  allowed  to  rise  during  the  act  of  vomiting,  but  to 
turn  to  the  side,  and  afterwards,  lying  on  his  back, 
with  the  feet  higher  than  the  head,  must  maintain 
perfect  rest. 

Alcoholic  stimulants  are  used,  and  external  heat  is 
of  importance,  with  gentle  friction  to  excite  the 
capillary  circulation. 

Incidental  Effects. 

The  action  of  the  skin  is  increased  in  an  indirect 
way  by  veratrum  and  the  secretion  of  bile  is  also 
stimulated.  The  temperature  is  quite  markedly 
lowered  by  full  doses,  and  various  incidental  effects, 
such  as  a  feeling  of  heat  and  prickling,  restlessness, 
anxiety,  dizziness,  dimness  of  vision,  unsteady  gait,  a 
dryness  of  the  mouth,  with  thirst,  choking,  nausea, 
and  vomiting,  may  appear  after  medicinal  doses. 

An  eruption  attended  with  itching  is  sometimes 
produced,  appearing  on  the  face  and  especially  round 
the  mouth.  With  suspension  of  the  drug  this  soon 
disappears. 

In  giving  veratrum,  if  no  special  orders  about  the 
pulse  have  been  given,  it  should  not  be  allowed  to  fall 
below  70.  A  fall  below  55  is  dangerous. 

Preparations. 

Tinctura  Veratri  Viridis. 
Tincture  of  Veratrum  Viride. 

Strength  10%.     Average  dose,  TTJ,  viii.-o.5  mil. 
Fluidextractum  Veratri  Viridis. 
Fluidextract  of  Veratrum  Viride. 

Average  dose,  Tl[  iss.-o.  i  mil. 
Norwood's  Tincture  is  a  saturated  tincture  and  is  unofficial. 

Veratrina,  Veratrine. 

A  compound  of  alkaloids  contained  in  the  seed  of 
Asagrcea  officinalis,  a  plant  of  the  veratrum  group. 


2$  6  MATERIA  MEDIC  A   FOR  NURSES. 

It  is  exceedingly  poisonous,  and  is  little  used  in- 
ternally. Poisonous  doses  cause  convulsions  and 
tetanus,  with  death  from  asphyxia.  Externally  it  is 
irritant,  causing  prickling  and  tingling,  redness  of  the 
skin,  numbness,  and  vesication.  The  unguent  is  a 
powerful  counter-irritant,  but  needs  to  be  used  with 
care,  special  pains  being  taken  not  to  get  it  near  the 
eyes,  as  it  may  cause  violent  irritation  of  the  con- 
junctivse. 

The  official  ointment  usually  requires  dilution. 

Preparations. 

Unguentum  Veratrinae.     Not  official. 
Veratrine  Ointment. 

Strength,  4%.     For  external  use. 

Oleatum  Veratrinae.    Not  official. 
Oleate  of  Veratrine. 

Strength,  2%.    For  external  use. 

Colchici  Semen,  Colchicum  Seed. 
Colchici  Cormus,  Colchicum  Corm. 

The  dried  ripe  seeds  and  corm1  of  Colchicum  autum- 
nale,  found  in  Europe.  The  active  principle  is  called 
colchicine. 

Physiological  Actions. 

Colchicum  is  a  sedative  to  the  central  nervous  sys- 
tem; a  diuretic ;  and  an  irritant  cathartic.  It  stim- 
ulates the  liver,  and  excites  the  action  of  the  skin. 
The  urine,  urea,  and  uric  acid  are  increased  in  amount 
by  moderate  doses  of  colchicum.  The  pulse  is  slightly 
reduced  in  frequency — about  12  beats  less  to  the  minute 
being  noticed  while  the  impression  lasts. 

1 A  part  of  the  stem  which  is  underground,  yet  not  the  actual 
root— a  bulb. 


THE    VEGETABLE  KINGDOM. 

Symptoms  of  Poisoning. 

Colchicum  in  poisonous  doses  is  an  aero-narcotic,1 
producing  a  combination  of  nervous  and  gastro- 
intestinal symptoms. 

Nausea,  violent  and  persistent  vomiting  and  retch- 
ing appear  first,  with  purging  of  serous,  mucous,  and 
bloody  matters,  attended  with  griping  pain. 

Tenderness  and  burning  are  felt  in  the  abdomen  and 
stomach;  the  urine  may  be  diminished  or  suppressed, 
while  in  some  cases  it  is  increased,  and  in  others  the 
kidneys  seem  unaffected  almost  to  the  last. 

Spasms  occur  frequently,  and  there  may  be  fatal 
convulsions.  The  circulation  fails,  the  pulse  becomes 
rapid  and  grows  feeble  and  thready,  the  skin  is  cold, 
livid,  and  covered  with  perspiration. 

Consciousness  remains,  and  death  results  from 
collapse. 

The  fatal  dose  is  small,  death  having  been  caused 
by  3  ss  -ii.  of  the  wine. 

Treatment  of  Poisoning. 

The  only  chemical  antidote  is  tannin,  though  it  is 
not  always  sure  in  its  action.  Emetics,  with  plenty  of 
warm  water,  and  castor  oil  must  be  given;  albuminous 
drinks  —  milk,  white  of  egg,  etc. —  and  demulcents 
freely  given,  and  stimulation  used  as  the  need  arises. 

Incidental  Effects. 

Colchicum,  even  in  small  doses,  may  produce  un- 
pleasant secondary  symptoms:  dizziness,  fulness  and 
pain  in  the  head;  pains  over  the  body;  numbness, 
redness,  prickling  or  smarting  sensations;  sneezing; 
running  at  the  eyes;  irritated  fauces;  coated  tongue; 
loss  of  appetite  or  nausea;  abdominal  uneasiness  or 
pain;  flatulence  or  borborygmi;  or  rectal  tenesmus 
may  be  observed. 

1 A  poison  which  is  irritant,  and  which  also  acts  on  the  brain 
and  spinal  cord. 


258  MATERIA   ME  DIG  A   FOR  NURSES. 

Preparations  of  Colchicum. 

Tinctura  Colchici  Seminis. 
Tincture  of  Colchicum  Seed. 

Strength,  10%.     Average  dose,  Tt[  xxx.-2  mils. 

Fluidextractum  Colchici  Seminis. 
Fluidextract  of  Colchicum  Seed. 

Average  dose,  TT[  iii.-o.2  mil. 

Colchicina. 
Colchicine. 

Average  dose,  gr.  1-2^-0.0005  Gm. 

Fam.  Graminetz. 
Ergota,  Ergot. 

Ergot  is  a  parasite  which  develops  in  rye,  taking 
the  place  of  the  grain,  and  having  the  appearance  of 
a  blackish  fungus.  It  is  a  complex  substance,  con- 
taining various  alkaloids  and  acids;  a  fixed  oil,  etc. 

Three  of  the  alkaloids  are  named  ecboline,  ergotine, 
and  ergotinum;  and  the  watery  extract  ergotin  con- 
tains all  the  important  constituents,  and  may  be  con- 
sidered to  represent  the  active  principles  of  ergot. 

Physiological  Actions. 

Ergot  is  specially  known  as  an  oxytocic,  exciting 
or  increasing  uterine  contractions;  and  as  a  haemos- 
tatic. 

In  the  latter  capacity  it  acts  by  contracting  the 
small  vessels,  thus  promoting  coagulation.  The  fre- 
quency of  the  pulse  is  lessened  by  ergot,  and  very 
large  doses  depress  the  heart  and  vaso-motor  centres 
and  lower  arterial  pressure. 

It  is  not  an  active  poison,  and  an  ounce  of  the  fluid 
extract  has  been  given  without  producing  serious 
symptoms. 


THE    VEGETABLE  KINGDOM.  259 

Symptoms  of  Poisoning. 

In  cases  where  poisoning  has  occurred  the  symptoms 
were  thirst;  gastric  irritation  and  diarrhoea;  a  small 
pulse;  burning  pain  in  the  feet;  and  sometimes  ting- 
ling and  cramps,  dizziness,  dilated  pupils,  and  a  feel- 
ing of  cold.  Before  death  there  are  convulsions.  In 
European  countries,  where  the  poorer  classes  live 
largely  on  rye  bread,  chronic  ergot-poisoning  is 
familiar,  and  has  at  times  prevailed  as  a  scourge. 
There  are  two  varieties  of  this  chronic  poisoning — the 
gangrenous  and  the  spasmodic, — but  it  is  unknown  in 
this  country,  and  need  not  be  described  here. 

Incidental  Effects. 

The  urine,  perspiration,  and  milk  are  reduced  in 
quantity  by  ergot.  After  taking  medicinal  doses,  one 
or  more  of  the  following  symptoms  may  be  observed: 
an  unpleasant  taste  in  the  mouth;  tickling  in  the 
throat;  nausea;  burning  pain  in  the  stomach  or  abdo- 
men, with  eructations  of  gas  or  diarrhosa;  headache; 
lassitude;  giddiness;  specks  before  the  eyes;  unsteady 
gait;  irregular  pulse;  chilly  feelings. 

Fluidextractum  Ergotae. 
Fluidextract  of  Ergot. 

Average  dose,  Tf[  xxx.-2  mils. 
Ergotin.     Not  official. 

Ergotin  is  prepared  under  trade  names  according  to 
different  formulae.  It  is  unreliable  and  often  inert. 
When  used  hypodermically  it  is  irritant  to  the 
tissues  and  may  produce  abscesses,  even  when  deeply 
given. 

Preparations  of  ergot  lose  their  strength  if  kept  for 
any  length  of  time. 


260  MATERIA  MEDICA  FOR  NURSES. 

Fain.  Composites 
Pyrethrum,  Pyrethrum,  Pellitory  Root. 

Is  the  root  of  a  perennial  plant  growing  in  northern 
Africa.  It  contains  a  volatile  oil,  resin,  and  pyrethrin, 
and  is  similar  in  nature  to  black  pepper.  It  is  a  local 
irritant.  It  is  a  specific  for  bed-bugs,  and  the  best 
remedy  ever  used  for  their  destruction  (Stiles).  The 
pyrethrum  powder,  pyrethrum  roseum,  is  dusted 
wherever  the  bugs  exist,  and  they  are  exterminated. 
It  should  be  used  once  every  week  for  three  weeks, 
in  order  to  kill  any  bugs  that  may  have  hatched  out 
in  the  meantime. 


Fam.  Filices. 
Aspidium,  Male  Fern. 

The  root-stock  of  Dryopteris  filix  mas,  a  European 
fern.  The  medicinal  principle  of  fern  is  an  oleoresin 
of  a  bitter,  nauseous  taste. 

It  is  an  anthelmintic,  specially  destructive  to  the 
tape-worm.  Although  less  irritating  than  some  others 
of  its  class,  it  may,  in  overdoses,  produce  severe  in- 
testinal irritation,  and  death  has  been  caused  in  an 
adult  by  taking  six  ounces. 

Fam.  Lycopodiacea , 
Lycopodium. 

The  dust,  or  sporules,  which  fills  the  spikes  of  a 
European  moss.  Collected  in  Switzerland  and  Ger- 
many, and  used  as  a  dusting  powder  for  infants  espe- 
cially; also  for  bed-sores,  etc.,  either  alone  or  mixed 
with  bismuth.  Lycopodium  is  inflammable,  and  is 
sometimes  called  vegetable  sulphur.  It  is  a  very  soft, 
fine  powder,  and  is  used  in  rolling  and  packing  pills 
and  suppositories. 


THE  VEGETABLE  KINGDOM.  261 

Diastasum,  Diastase. 

A  mixture  obtained  from  an  infusion  of  malt,  which 
has  the  power  of  converting  50  times  its  own  weight  of 
potato  starch  into  sugars. 

Average  dose,  gr.  viii.-o.5  Gm. 


THE  ANIMAL  KINGDOM. 

Adeps  Lanae  Hydrosus,  Hydrous  Wool  Fat, 
Lanolin. 

A  combination  of  fats  obtained  from  sheep' s  wool.  It 
does  not  become  rancid,  nor  form  soaps,  and  is  rapidly 
absorbed  by  the  skin. 

It  is  used  as  a  simple  emollient,  and  as  a  means 
of  introducing  medicine  into  the  system. 

Saccharum  Lactis,  Sugar  of  Milk,  Lactose. 

A  crystallized  sugar  obtained  by  evaporation  from 
the  whey  of  milk,  and  specially  suitable  for  use  in 
preparing  baby  foods.  I  Gm.  dissolves  in  2.6  mils  of 
boiling  water.  It  readily  absorbs  odors. 

Pepsinum,  Pepsin. 

Pepsin  is  one  of  the  normal  constituents  of  the 
gastric  juice,  and,  with  the  aid  of  hydrochloric  acid, 
changes  albumins  into  peptones,  in  which  form  they 
are  readily  diffusible  and  capable  of  being  absorbed 
into  the  blood. 

Pepsin,  as  used  in  medicine,  is  a  preparation  made 
from  the  mucous  membrane  which  lines  the  stomach  of 
the  pig. 

It  is  made  by  cleaning  the  mucous  lining,  scraping 
it,  drying  the  pulp  at  a  temperature  of  100°  F.,  and 
pulverizing  it.  The  power  is  a  light  yellow- brown, 
almost  insoluble  in  water,  and  of  slightly  salty  taste. 
It  may  be  taken  dry  on  the  tongue  or  given  in  milk. 

Average  dose,  gr.  viii.-o.5  Gm.,  with  meals  or 
immediately  after. 

262 


THE  ANIMAL  KINGDOM.  263 

Pancreatinum.  Pancreatin. 

A  preparation  made  from  the  pancreas  of  the  pig. 
Pancreatic  extract  digests  starchy  and  proteid  sub- 
stances, and  pancreatin,  while  not  given  alone  as  a 
medicine,  is  very  largely  used  in  preparing  artificially 
digested  foods,  viz.:  pancreatized  inilk,  eggs,  oysters, 
soups,  broths,  etc. 

The  principle  followed  in  making  pancreatized  food 
is  that  by  subjecting  it  to  the  action  of  pancreatin  in 
the  presence  of  moderate  heat,  the  process  of  digestion 
takes  place,  and  may  be  made  complete  or  only  partly 
so,  according  to  the  length  of  time  during  which  they 
are  in  contact. 

The  digestive  process  is  stopped  by  heat  at  the 
boiling  point,  or  by  extreme  cold.  For  this  reason 
artificially  digested  foods,  having  reached  the  point 
desired,  are  either  brought  quickly  to  a  boil  or  else 
are  put  on  ice. 

Milk,  if  thoroughly  digested,  has  a  slightly  bitter 
taste,  which  is  not  noticeable  if  the  process  has  been 
short  or  complete. 

The  ferments,  pepsin,  pancreatin,  and  diastase, 
which  promised  so  much  for  dyspepsia,  and  all  the  ills 
of  bad  digestion,  have  passed  into  disuse,  and  even  the 
use  of  alkalies  and  acids  is  not  so  prevalent  as  it  once 
was,  many  physicians  preferring  to  use  remedies  that 
strengthen  the  digestive  organs  and  add  to  their 
normal  function  by  putting  them  into  a  condition  to 
furnish  the  ferments  in  proper  consistency  and  propor- 
tion. Many  of  the  patented  digestive  compounds  con- 
tain diastase,  and,  while  aiding  the  breaking  up  of 
starch  in  the  alimentary  canal,  are  detrimental  to  the 
cells  and  the  function  of  the  parts.  Average  dose,  gr. 
via. -0.5  Gm. 

Adeps,  Lard. 

Lard  consists  of  a  fluid  oil,  olein,  with  stearin  and 
palmitin,  which  are  solid  oils. 

It  is  used  as  the  basis  of  various  official  ointments. 


264  MATERIA    MEDICA    FOR  NURSES. 

Benzoinated  Lard. 
Ten  Gm.  of  benzoin  in  1000  Gm.  of  lard. 

Adeps  Lanse.  Wool  Fat. 
The  fat  of  the  wool  of  sheep. 

Cetaceum.    Spermaceti. 

A  fatty  substance  obtained   from  the  head  of  the 
sperm  whale,  and  resembling  white  wax. 
It  is  used  as  an  emollient. 

Oleum  Morrhuae.  Cod-Liver  Oil. 

The  oil  obtained  from  the  liver  of  Gadus  morrhua, 
and  other  species  of  codfish.  An  exceedingly  com- 
plex substance,  containing  glycerin,  acetic  acid,  and 
several  fatty  acids,  iodine,  chlorine,  and  traces  of 
bromine,  phosphorus,  and  phosphoric  acid,  and  various 
other  constituents.  There  are  three  varieties:  the  pale 
yellow,  light  brown,  and  dark.  The  pale  oil  is  the 
purest,  being  prepared  by  forcing  steam  at  high  pres- 
sure through  the  livers,  end  is  less  nauseous  than  the 
dark  oil.  This  is  the  official  variety, 

Physiological  Actions. 

Cod-liver  oil  is  an  alterative  to  the  general  nutrition 
in  various  diseased  conditions,  and  is  more  truly  a  food 
than  a  medicine,  as  it  supplies  the  need  of  the  tissues 
for  fat.  Fat  produces  force,  and  is  utilized  by  every 
part  of  the  body  in  quantities  directly  proportioned  to 
the  activity  of  the  different  tissues.  The  nervous 
system  needs  the  largest  amount;  the  muscular,  the 
next  largest.  Having  been  elaborated  by  the  liver  of 
the  fish,  cod-liver  oil  is  more  easily  digested  than 
other  fats. 

The  smell  of  cod-liver  oil  is  unpleasant  and  some- 
times causes  nausea.  This  may  be  avoided  by  taking 


THE  ANIMAL  KINGDOM.  26$ 

some  peppermint  into  the  mouth  just  before  taking  the 
oil,  and  by  avoiding  bringing  it  into  direct  line  with 
the  nose.  All  patients  do  not  know  how  to  take  oil; 
by  tossing  it  into  the  mouth  and  not  allowing  the  lips 
to  touch  it,  it  is  less  disagreeable. 

It  is  best  to  mix  no  other  medicines  with  cod-liver 
oil,  except  hypophosphites.  If  other  medicines  come 
at  the  same  time  they  should  be  given  separately,,  It 
may  be  given  in  any  of  the  ways  in  which  castor  oil  is 
given;  it  is  almost  always  well  taken  if  floated  in  a 
little  brandy  or  wine,  or  lemon  juice.  These  precau- 
tions about  giving  it  do  not  necessarily  apply  to  the 
various  emulsions  of  oil,  which  are  usually  not  at  all 
hard  to  take.  The  proper  time  to  administer  cod- 
liver  oil  is  when  digestion  is  at  its  height. 

In  overdoses,  or  when  first  taken,  it  may  disorder 
the  stomach,  or  cause  temporary  relaxation  of  the 
bowels.  It  sometimes  causes  an  eczema. 

Emulsions  of  cod-liver  oil  spoil  in  a  short  time,  and 
patients  should  not  be  encouraged  to  buy  the  ready- 
made  preparations  in  the  shops. 

In  giving  cod-liver  oil  the  faeces  must  be  watched, 
to  see  if  any  is  carried  away  undigested. 

When  cod-liver  oil  cannot  be  taken  by  mouth  it  may 
be  administered  by  inunction,  a  few  drams  of  the  oil 
being  rubbed  into  the  skin  of  the  chest  or  abdomen  at 
night  before  retiring.  When  used  in  this  way  it  is 
especially  valuable  for  children  with  malnutrition. 

Average  dose,  3  iiss.-io  mils,  from  three  quarters  of 
an  hour  to  an  hour  after  meals, 

Cantharis,  Cantharides,  Spanish  Flies. 

The  dried  and  powdered  bodies  of  the  Cantharis 
vesicatoria,  a  beetle  of  Southern  Europe.  The  powder 
is  grayish-brown  and  specked  with  minute  greenish 
spangles  from  the  wing-cases  of  heads.  It  has  a 
strong  unpleasant  odor.  The  active  principle  is 
cantharidin,  an  active  irritant,  besides  which  it  con- 
tains a  volatile  oil  and  fatty  substances. 


266  MATERIA   MEDICA   FOR  NURSES. 

Physiological  Actions. 

Externally  cantharides  is  vesicant.  When  applied 
to  the  skin  a  feeling  of  heat  and  burning  is  felt  in  a 
few  hours,  and  small  vesicles  form  which  unite  in  one 
large  blister. 

The  average  time  required  for  this  result  is  about 
eight  hours.  The  action  of  cantharides  is  attended  with 
less  injury  to  the  skin  than  that  of  any  other  vesicant. 
No  pus  is  formed  during  the  healing  process,  and  no 
scar  is  left  by  the  blister. 

Internally  cantharides  is  irritant  to  mucous  mem- 
brane, and  if  given  medicinally  must  be  largely 
diluted.  It  enters  the  blood  from  the  stomach  and 
also  from  blistered  surfaces,  and  is  slowly  excreted  by 
the  kidneys.  In  small  doses  it  causes  diuresis  with 
some  irritation  of  the  urinary  organs,  and  larger  doses 
produce  strangury. 

Symptoms  of  Poisoning. 

When  a  poisonous  dose  of  cantharides  is  taken,  the 
first  symptoms  are  burning  in  the  oesophagus  and 
stomach,  a  constricted  feeling  about  the  throat,  gastric 
and  abdominal  pain,  with  vomiting  and  in  most  cases 
diarrhoea. 

If  the  powder  has  been  taken,  the  small  green  specks 
may  be  seen  in  the  matter  vomited,  which  is  at  first 
mucous,  then  bilious,  and  finally  serous.  The  dis- 
charges from  the  bowels  have  the  same  characteristics 
and  are  scanty,  frequent,  and  accompanied  by  tenes- 
mus.  There  is  frequently  salivation  with  swelling  of 
the  salivary  glands.  The  pulse  is  weak  and  rapid, 
and  death  usually  occurs  quickly  from  collapse  caused 
by  the  gastro  -  intestinal  inflammation,  but  if  it  is 
delayed  for  a  few  hours  the  symptoms  of  irritation  of 
the  urinary  apparatus  appear,  beginning  with  pains  in 
the  back,  and  ending  in  strangury,  with  scanty,  albu- 
minous, or  bloody  urine,  and  tenesmus  of  the  bladder. 


THE  ANIMAL  KINGDOM.  267 

Treatment  of  Poisoning. 

There  is  no  antidote  to  cautharides,  and  the  stomach 
must  be  at  once  emptied,  and  as  thoroughly  as  possible 
washed  out;  large  quantities  of  albuminous  and  muci- 
laginous drinks  given;  warm  baths  to  relieve  the 
strangury,  and  stimulants  if  necessary.  No  oils  or 
glycerin  must  be  given,  as  they  aid  in  the  absorption 
of  the  poison. 

It  is  to  be  remembered  that  constitutional  effects  are 
sometimes  produced  by  even  a  moderate  blister,  and  if 
necessary  the  blister  must  be  removed  and  the  part 
washed  with  soap  and  water. 

Cautions. 

Before  applying  a  blister  the  spot  should  be  washed 
with  soap  and  water;  dried;  washed  again  with  alco- 
hol or  ether,  and  briskly  rubbed  for  a  moment  or  two. 
Absorption  then  takes  place  more  quickly.  A  blister 
should  never  be  applied  over  a  bony  prominence,  as 
sloughing  may  follow,  the  circulation  in  such  parts 
being  sluggish.  On  tender  skins  vesication  is  soon 
produced  and  the  blister  must  be  carefully  watched 
lest  the  action  be  too  severe.  On  coarse  skins,  or  in 
places  where  it  is  thick,  as  on  the  scalp  or  at  the  knee- 
joint,  more  time  is  needed. 

Hairs  must  be  cut  away,  or  shaved.  A  blister 
should  not  be  left  on  a  child's  skin  long  enough  to 
rise,  but  should  be  removed  when  redness  appears,  and 
poultices  be  applied  to  finish  the  process. 

Thyroideum  Siccum. 
Dried  Thyroids. 

The  thyroid  glands  of  animals  used  for  food  by  man, 
dried  and  powdered,  producing  a  yellowish  powder, 
with  a  slight,  peculiar  odor,  and  soluble,  partially,  in 
water.  Average  dose,  gr.  iss.-o.  i  Gm. 


268  MATERIA  MEDIC  A  FOR  NURSES. 

Suprarenalum  Siccum.     (See  p.  286.) 
Dried  Suprarenals. 

The  suprarenal  glands  of  animals  used  as  food,  dried 
and  powdered,  producing  a  yellowish -brown  powder, 
partially  soluble  in  water. 

Average  dose,  gr.  iv.-o.25  Gm. 

Hypophysis  Sicca.     Desiccated  Pituitary  Body. 

Manufactured  from  a  small  gland  at  the  base  of  the 
brain  of  the  ox. 

The  corresponding  gland  in  man  secretes  a  substance 
which  contracts  the  blood-vessels  and  acts  as  a  stimulant 
to  the  uterine  muscle. 

Uses. 

To  aid  in  the  control  of  hemorrhage  and  to  overcome 
uterine  inertia. 

Ovarian  Extract.     Not  official. 

Prepared  from  the  ovaries  of  pigs.  Used  to  relieve  the 
symptoms  of  the  menopause  when  induced  artificially  : 
e.  g.y  by  extirpation  of  the  ovaries. 

Serum  Antidiphthericum. 
Antidiphtheric  Serum.     Diphtheria  Antitoxin. 

A  fluid  separated  from  the  coagulated  blood  of  a 
horse,  immunized  by  inoculation  with  diphtheria 
toxin.  It  is  a  yellowish-brown  powder,  odorless,  and 
slightly  transparent.  It  loses  strength,  and  the  date 
of  its  manufacture  should  be  known,  also  its  strength, 
the  name  of  the  preservative,  and  the  date  beyond 
which  it  will  not  ictain  its  strength.  The  standard 
must  be  that  approved  by  the  United  States  Public 
Health  service.  It  must  have  a  potency  of  not  less  than 
250  antitoxic  units  per  mil. 

Average  dose,  hypodermic,  10,000  units. 

Average  dose,  protective,  1000  units. 


THE  ANIMAL  KINGDOM.  269 

The  U.  S.  P.  also  recognizes  the  Purified  Antidiph- 
theric  Serum,  Diphtheric  Antitoxin  Globulins,  a  solution 
in  physiological  solution  of  sodium  chloride,  of  certain 
antitoxic  substances  obtained  from  the  blood  serum  or 
plasma  of  the  horse  or  other  large  domestic  animal 
which  has  been  properly  immunized  against  diphtheria 
toxin;  and  the  Serum  Antidiphthericum  Siccum,  Dried 
Diphtheria  Antitoxin,  which  must  be  hermetically 
sealed.  The  average  dose  of  each  is  the  same  as  of 
diphtheria  antitoxin.  (See  p.  283.) 

Virus  Vaccinicum,  Vaccine  Virus,  Glycerinated 
Vaccine  Virus,  Smallpox  or  Jennerian 
Vaccine. 

The  pustules  of  vaccinia  or  cowpox  from  healthy 
vaccinated  cows  or  calves.  (See  p.  285.) 

Lactic  Acid  Bacilli. 

Bacillus  Bulgarians.     Not  official. 

Cultures  of  these  bacilli  in  solid  or  liquid  form  are 
given  to  lessen  intestinal  fermentation  and  to  relieve 
various  conditions  resulting  from  it. 

A  number  of  preparations  of  milk  containing  bacilli 
bulgaricus  are  on  the  market,  as  Fermillac,  etc. 


POISONS  AND  THEIR  TREATMENT. 

Poisons  may  be  conveniently  classified  in  three 
groups: 

1.  Corrosives,  or  those  which  act  rapidly  at  the  point 
of  contact  with  the  tissues,  causing  erosion.    Such  are; 

Acids,  alkalies,  corrosive  salts,  animal  and  vegetable 
poisons,  and  gases. 

2.  Irritants,   or  those  which  irritate  the   tissues  at 
the  point  of  contact,  and  may  cause  erosions  if  con- 
centrated for  any  length  of  time  on  the  tissues.     This 
group  includes  alcohol,  ether,  the  metals,  and  some 
salts,  carbon  monoxide,  phosphorus,   and  turpentine. 

3.  Functional,  or  those  which  act  upon  the  function 
of  organs  or  systems.     Here  we  have  aconite,  bella- 
donna, chloral,  CO2,  gelsemium,  lobelia,  strychnine, 
opium,  hemlock,  mushrooms. 

In  group  i  death  is  usually  sudden.  If  not  immed- 
iate, then  administer  by  mouth  the  antidotal  treatment. 
Do  not  use  the  stomach-tube  unless  there  is  little  ero- 
sion. Bmetics  are  employed  with  great  risk  in  these 
cases.  The  stomach-pump  is  always  preferable,  even 
with  great  erosion. 

In  group  2  the  first  thing  to  do  is  to  insert  the 
stomach-tube  and  wash  out  the  stomach  thoroughly. 
Kmetics  may  be  employed  instead.  Cathartics  may  be 
given  and  antagonistic  treatment  if  necessary.  Oils, 
milk,  eggs,  and  demulcent  drinks  are  useful. 

In  group  3  treatment  should  proceed  according  to 
the  drug  that  caused  the  poisoning,  and  according  to 
the  symptoms  that  develop. 

In  poisoning  from  snake  bite  or  scorpion  sting,  use 
a  one-per-cent.  solution  of  chromic  acid  locally,  and 
give  strychnine  hypodermically.  Use  no  alcohol. 

In  any  case,  keep  cool ;  take  one  minute  to  collect 
yourself,  then  go  to  work.  Command  others.  The 
result  may  surprise  you,  even  in  the  most  hopeless 
cases. 

270 


A  TABLE  OF  POISONS, 
THEIR  ANTIDOTES  AND  ANTAGONISTS. 

Antidotes  act  upon  the  poisons  in  the  alimentary 
canal,  and  by  combination  or  removal  prevent  their 
toxic  action. 

Antagonists  counteract  the  effect  of  the  poison  upon 
the  system,  and  may  be  used  after  its  absorption,  when 
antidotes  are  too  late. 


POISON. 

CHARACTERISTIC 
EFFECT. 

ANTIDOTAL 
TREATMENT. 

ANTAGONISTIC 
TREATMENT. 

Acids- 
Sulphuric. 
Nitric. 
Hydrochloric. 
Phosphoric. 

I,ocal  action—  corro- 
sive. 

Alkalies—  as  Soda, 
Magnesia,  Chalk, 
I^ime-water, 
White-  wash,  Soap. 
Oil;  Albumen^  Milk. 
Demulcent  drinks. 

Stimulants. 
Opium  for  pain. 

Carbolic. 

Rapid  action  —  col- 
lapse. 

50  #  alcohol. 
Stomach-tube, 
lyime-water  ;  Syrup 
of  I^ime. 
Milk. 
Vegetable  d  e  m  u  1  - 
cent  drinks. 
No  oil. 

Atroplne. 
Chloral? 
Stimulants. 
External  heat. 

Oxalic. 
Tartaric. 
Acetic. 

JPreguent  accidental 
mistake  —  Epsom 
salt.    60  %  die. 

Stomach-tube. 
L,ime  with  water  or 
milk.    Emetics. 
Bland  drinks. 

Stimulants. 
External  heat. 

Hydrocyanic. 

Acts  too  quickly  for 
any  antidote  to  be 
of  use. 

Stomach-tube. 
Emetics. 

Artificial      respira- 
tion. 
Stimulants,      hypo 
dermically  and  by 
inhalation. 
Cold  water  to  head 
and  spine. 

tconlte. 

A  few  drops  kill  ! 
Tingling  sensation. 

Stomach-tube. 
Empty     and    wash 
out  stomach. 

Recumbent  position. 
Artificial       respira- 
tion. 
Heat.     Atr  opine. 
Hypo    Ether,   Digi- 

271 


2/2 


MATERIA  MEDICA  FOR  NURSES. 


W3ISON. 

CHARACTERISTIC 
EFFECT. 

ANTIDOTAL 
TREATMENT. 

ANTAGONISTIC 
TREATMENT. 

Alcohol. 

Acute  —  maiden- 
blush. 
Chronic  —  nosegay. 

Stomach-tube. 
Emetics. 

Cold  to  head;  heat  to 
extremities        In- 
halation    of    Am- 
monia. 
Electricity.    Coffee. 

Alkalies- 
Ammonia. 
Caustic  Potash. 
Caustic  Soda. 
Lime. 

Dissolve  tissues. 
Cause    rupture    or 
stricture. 

Dilute  acids. 
Vinegar. 
I^emon  juice. 
Milk. 
Oil. 

For  Ammonia  — 
Aconite. 
Digitalis. 
Cold  air. 

Anaesthetics  — 
Chloroform. 
Ether,  etc. 

Produce  sleep. 

Remove  anaesthetic. 

Artificial       respira- 
tion. 
Inversion  of  patient. 
Atropine  ;       Strych- 
nine. 
Stimulants.    Heat. 

Antimony  — 
Tartar  Emetic. 
Wine    of   Anti- 
mony. 
Syrup  of  Squills. 

Rarely  used. 
Cause  vomiting. 

Stomach-tube. 
Wash  out  stomach. 
Tannic  acid  —  as  tea, 
etc. 
Demulcent  drinks. 

Opium  for  pain. 
Alcohol. 

Arsenic  — 
Foyer's     Solu- 
tion. 
Paris  Green. 
Rough  on  Rats. 
Arsenous  Acid. 

Acute  —  "rice  water 
stools." 
Chronic  —  puffy  eyes. 

Stomach-  tube. 
Emetics.     Hy- 
drated    Oxide   of 
Iron    with    Mag- 
nesia.      Dialyzed 
Iron.    Demulcent 
drinks. 

Stimulants. 
Opium  for  pain. 

Belladonna  — 
Atropine. 
Hyoscyamus  and 
Stramonium. 

"  Wild  as  a  hare,  dry 
as  a  bone,  red  as  a 
beetl" 

Stomach-tube. 
Emetics. 
Tannic  acid. 

Chloroform,    Ether, 
Caffeine. 
Artificial       respira- 
tion. 
External  stimulants. 

Chloral. 

With   alcohol  — 
"knock-out 
drops." 

Wash   out  stomach 
with  tea  or  coffee 
and  give  these  per 
rectum. 

Heat.     Mustard  ap- 
plications. 
Artificial       respira- 
tion. 
Alcoholic       stimu- 
lants. 
Atropine  (carefully). 

Cocaine, 

Hypodermic  habit. 
Two  grains  poison. 

Remove  cause. 
Stomach-tube. 

Alcohol.    Opium. 
Chloroform. 
Nitrite  of  AmyL 

Copper. 
Bluestone,  etc. 

Causes  vomiting. 

Albumens  —  egg, 
milk. 
Wash  out  stomach 
after. 
Demulcents. 

Digital!*, 

Irregular      circula- 
tion. 

Stomach-tube. 
Emetics. 
Tannic  acid. 

Recumbent  position. 
Aconite? 

Stimulants. 

A   TABLE  OF  POISONS. 


273 


POISON. 

CHARACTERISTIC 
EFFECT. 

ANTIDOTAL 
TREATMENT. 

ANTAGONISTIC 
TREATMENT. 

3ases  — 
Illuminating. 
Carbon  dioxide. 
Chlorine. 
Nitrous  Oxide. 

Anaesthetic. 

Remove    patient 
from  gas. 

Fresh  air. 
Artificial      respira- 
tion. 
Stimulants. 
Oxygen  inhalation. 
Friction  of  body  sur- 
face. 

Gelsemium— 
Coniine. 
Sparteine. 

Depressing      heart 
and  respiration. 

Emetics.    Stomach- 
tube. 

Opium?  Stimulants. 
Artificial       respira- 
tion. 
Heat.    Electricity. 

Iodine. 

Colored  vomitus. 

Starch  or  flour  with 
water. 
Stomach-tube. 
Emetics. 

Stimulants  hypoder« 
mically. 

Lead- 
Sugar  of  Lean, 
etc. 

Acute  —  causes  vom- 
iting. 
Chronic  —  colic,  par- 
alysis, blue  gums. 

Dilute  sulphuric  acid 
and  lemon  juice. 
Magnesia.      Albu- 
mens.     Stomach- 
tube.    Emetics. 

Opium  for  pain* 
External  heat. 

Lobelia. 

Causes  vomiting. 

Tannic  acid  to  wash 
out  stomach. 

Stimulants. 
Strychnine. 

Mercury- 
Corrosive  Subli- 
mate, etc. 

Acute  —  corrosive. 
Chronic  —  salivation, 
etc. 

White  of  an  egg  to 

lAMr*"""- 
Stomach-tube. 

Mushrooms 
(non-edible). 

Lake  the  blood. 
Paralyze  the  heart. 

Wash  out  stomach. 
Cathartic. 

Atropine. 
Stimulants. 

salt  infusion. 

Nitrate  of  Silver— 
"Lunar  Caustic." 

Scarification. 

Common  salt. 
Stomach-tube. 

Opium  — 
Laudanum. 
Paregoric. 
Morphine,  etc. 

"  Pin-point  pupils." 
Odor  of  breath. 

Stomach-tube. 
Emetics. 
Permanganate      of 
Potassium. 

Artificial       respira- 
tion. 
Electricity. 
External  heat  (care- 
fully). 
Coffee  by  mouth  and 
rectum. 
Atropine  (with  care). 

Phosphorus. 

Garlic  odor. 

Stomach-tube 
Emetics. 
Copper  Sulphate. 
No  fats  or  oils. 
Old  oil  of  Turpen- 
tine. 

Alkalies. 
Heat. 

Strychnine. 

Convulsions, 

Tannic  acid. 
Stomach  -  tube     or 
emetic  quickly. 

Quiet.      Chloroform 
for  convulsions. 
Chloral.    Opium. 

18 


2/4 


MATERIA  MEDICA  FOR  NURSES. 


POISON. 

CHARACTERISTIC 
EFFECT. 

ANTIDOTAL 
TREATMENT. 

ANTAGONISTIC 
TREATMENT. 

ADDENDA. 
Chlorates. 

Depression. 
I<ake  the  blood. 

Stomach-tube. 

Stimulants. 
Alkaline  drinks. 
Diuretics.    Water. 

Coal  Tar  Antipy- 
retics— 
Antifebrin. 
Antipyrin. 
Acetanilid, 
Phenacetin,  etc. 

Depression. 
I^afce  the  blood. 

Stomach-tube. 
Stop  drug. 

Stimulants. 
Heat. 
Oxygen  inhalation. 

Cantharides. 

Blisters*. 

Stomach-tube. 
Emetics. 
Epsom  salt. 
Demulcents.  Aboil. 

Stimulants. 
Heat  to  abdomen. 
Opium  for  pain. 

EMETICS. 

The  use  of  drugs  to  produce  emesis  is  not  so  prev- 
alent as  it  was  years  ago,  and  if  it  becomes  necessary 
to  cause  vomiting,  the  simpler  means  (such  as  drink- 
ing large  draughts  of  tepid  water  and  putting  one's 
finger  down  the  throat)  should  be  tried  whenever 
possible. 

Stomach-tube.— -We  have  at  present  in  the  stomach- 
tube  an  efficient  means  of  emptying  the  stomach,  and 
one  that  is  simple,  easily  accomplished,  and  does  not 
cause  the  patient  great  inconvenience  and  danger  as 
in  the  use  of  zinc  or  copper  sulphate,  ipecac  or  tartar 
emetic,  provided  one  is  acquainted  with  the  use  of  the 
stomach-tube.  For  ordinary  stomach  washing,  etc., 
the  patient  should  be  seated  in  a  chair  and  a  rubber 
sheet  placed  around  the  neck,  the  end  of  the  sheet 
resting  in  a  basin  between  the  patient's  feet.  The 
tube  should  be  taken  from  cold  water  and  passed  care- 
fully and  rapidly  down  into  the  stomach,  the  operator 
standing  behind  the  patient  and  grasping  the  tube 
firmly  with  the  fingers  of  t!ie  two  hands.  The  patient 
should  be  told  to  hold  the  head  forward  and  allow  the 
tube  to  pass  down  the  throac.  As  soon  as  a  feeling  of 
choking  or  shortness  of  breath  is  experienced  a  deep 
breath  should  be  taken.  The  tube  should  enter  to  a 
distance  of  about  30  cm.  The  stomach  may  then  be 
washed  out  with  warm  water,  and  such  drugs  as  neces- 
sary administered,  leaving  them  in  the  stomach.  While 
operating,  the  tube  should  be  held  firmly  just  at  the 
patient's  teeth  that  it  be  not  forced  out  by  reflex  peri- 
stalsis of  the  oesophagus,  or  by  other  means. 

Mustard. — One  teaspoonful  of  mustard  to  a  teacup- 
ful  of  warm  water  may  be  given  to  produce  vomiting. 

275 


2/6  MATERIA  MEDICA  FOR  NURSES. 

Repeat  in  ten  minutes,  if  necessary,  and  keep  on  re- 
peating until  the  desired  effect  is  produced.  Be  sure 
that  the  mustard  is  removed  from  the  patient's  stomach 
before  leaving  him.  Mustard  should  not  be  used  in 
any  condition  of  inflammation  of  the  stomach. 

Soap-suds  ;  Salt. — Either  of  these  in  small  amounts 
with  tepid  water  will  prove  effective  in  producing 
vomiting  and  is  to  be  used  in  preference  to  more  drastic 
remedies. 

Ammonium  Carbonate. — This  is  a  very  safe  and 
effective  emetic,  being  at  the  same  time  a  rapidly  dif- 
fusible stimulant  and  expectorant.  It  may  be  given  in 
doses  of  gr.  30,  2  Gm.,  largely  diluted,  and  in  milk. 

Ipecacuanha. — The  action  of  this  drug  is  similar  to 
that  of  the  above,  but  it  is  slower  in  its  action.  It  is 
used  as  an  aid  to  other  emetics,  or  for  children  to  assist 
expectoration,  or  in  old  persons,  or  those  who  are  very 
weak.  It  is  safe  and  not  depressing.  Dose,  4-6  fl. 
dr.,  15-20  Gm.,  of  the  wine  of  ipecac,  given  every 
quarter  of  an  hour  until  the  desired  effect  is  produced. 
Large  draughts  of  tepid  water  hasten  its  action. 

Apomorphine. — Apomorphine  is  injected  hypoder- 
mically  when  rapid  action  is  necessary,  when  the 
stomach  is  inflamed,  or  if  the  patient  is  unable  to 
swallow.  It  should  not  be  given  unless  the  nervous 
mechanism  is  intact.  After  irritant,  corrosive,  or  nar- 
cotic poisons  the  stomach-tube  is  better.  Dose,  gr. 
•n>-£,  0.006-0.01  Gm.  Vomiting  usually  takes  place  in 
from  four  to  ten  minutes.  Repeat  with  caution,  if 
necessary. 

Sulphate  of  Zinc. — This  is  a  specific  emetic,  acting 
promptly,  without  absorption,  and  causes  little  nausea 
or  depression.  Dose,  gr.  15-20,  1.0-2.0  Gm.,  largely 
diluted  with  warm  water  and  repeated  in  fifteen  min- 
utes if  necessary. 

Sulphate  of  Copper.— This  is  rarely  employed  as  an 
emetic,  but  is  rapid  in  its  action  when  used.  It  is  ex- 
tremely irritant  and  should  not  be  repeated  if  not  at 
first  effective. 

Tartar  Emetic.— This  old  remedy  has  fallen  into 


EMETICS.  277 

disuse  on  account  of  its  depressing  effect  and  slow  re- 
sults. Any  dose  large  enough  to  produce  emesis  also 
produces  depression  both  before  and  after  the  act  of 
vomiting,  and  the  patient  is  usually  left  in  an  ex- 
hausted if  not  critical  condition.  Dose,  gr. 
0.003-0.06  Gm. 


HYPODERMIC  ADMINISTRATION  OF 
DRUGS. 

This  method  of  giving  drugs  is  growing  steadily  in 
favor.  The  best  location  for  the  injection  of  a  drug  is 
in  the  extensor  surfaces  of  the  extremities,  and  in  the 
back,  chest,  or  abdomen,  avoiding  the  region  of  large 
blood-vessels  and  nerves.  The  amount  administered 
is  about  one  half  the  dose  usually  given  by  mouth. 
Nearly  all  drugs  used  hypodermically  are  put  up  in 
tablet  form,  being  made  readily  soluble  and  especially 
for  the  purpose.  The  nurse  becomes  familiar  with  the 
various  forms  and  sizes  of  syringes  in  use  for  the  giv- 
ing of  hypodermics,  and  the  care  and  sterilization  of 
these  is  a  part  of  her  instruction  from  nursing  text- 
books and  in  practice  in  the  wards  of  her  hospital. 

There  are  two  ways  of  making  the  injections,  super- 
ficial and  deep.  In  the  first,  after  having  used  at  least 
two  successive  applications  of  alcohol  by  means  of  a 
sterile  sponge  or  a  bit  of  absorbent  cotton  to  cleanse  the 
part,  the  skin  is  grasped  between  the  thumb  and 
fingers  of  the  left  hand  while  the  needle  is  thrust  with 
the  right  hand  on  a  slant  to  the  depth  of  one  centimetre, 
when  it  is  withdrawn  a  short  distance  and  the  fluid  is 
slowly  forced  into  the  tissues.  Gentle  kneading 
around,  but  not  on,  the  point, of  injection  and  slight 
pressure  over  the  part  will  aid  in  the  absorption  of  the 
fluid,  help  to  prevent  abscess  formation,  and  allay 
pain. 

The  second  method,  deep  or  intramuscular  injec- 
tion, is  useful  with  irritant  drugs,  and  with  the  same 
precautions  as  in  the  other  method  the  needle  is  in- 
serted deeply  and  swiftly  into  the  muscular  tissues  of 
the  back,  chest9  abdomen,  buttocks,  or  preferably  the 

273 


HYPODERMIC  ADMINISTRATION  OF  DRUGS.    279 

anterior  surface  of  the  thigh,  to  the  depth  of  three  to 
five  cm.,  at  the  same  time  stretching  the  skin  tight 
over  the  part.  The  fluid  is  forced  quickly  out  of  the 
syringe,  and  the  tissues  around  the  point  of  its  inser- 
tion are  kneaded  deeply  for  about  five  minutes. 

Morphine  and  Strychnine. — These  drugs  are  usually 
injected  superficially  about  the  fleshy  part  of  the  shoul- 
der. They  may  be  put  in  lower  down  on  the  arm  or 
in  other  parts  of  the  body. 

Cocaine. — This  is  usually  administered  as  a  local 
anaesthetic,  and  in  this  way  may  be  injected  into  any 
part  of  the  body,  or  dropped  into  the  eye  or  ear,  or 
sprayed  into  the  nose  or  throat.  For  hypodermic  in- 
jections, the  needle  should  be  inserted  along  the  line  of 
the  proposed  incision — when  one  is  to  be  made — and 
the  cocaine  forced  in,  a  little  at  a  time,  removing  the 
needle  and  reinstating  it  within  the  limit  of  anaesthesia 
with  every  mil  of  the  fluid  used.  The  injection  should 
be  completed  at  least  five  minutes  before  the  incision  is 
made.  Not  more  than  two  grains  of  cocaine  should 
be  administered  at  one  time  for  fear  of  poisoning. 

Antitoxin. — One  usually  administers  this  remedy 
into  the  tissues  of  the  back,  buttocks,  or  thigh,  pref- 
erably between  the  shoulder-blades  or  in  the  lumbar 
muscles.  Rubbing  and  kneading  the  region  adjacent 
to  the  point  of  injection  is  an  aid  to  the  efficiency  of 
the  injection. 

Salt  Solution. — The  apparatus  necessary  for  this  is 
a  graduated  bottle,  a  rubber  tube,  and  a  needle.  Ster- 
ilized normal  salt  solution  (.9  of  i  $)  should  be  kept 
on  hand,  and  when  wanted  for  use  heated  to  a  tem- 
perature of  110°  F.  and  maintained  at  that  point,  em- 
ploying a  thermometer  to  register  it.  The  bottle  should 
be  suspended  at  a  height  of  three  to  six  feet  above  the 
patient.  The  fluid  is  injected  into  the  tissues  behind 
the  breast  or  into  the  thigh.  The  needle  should  be 
inserted  well  into  the  tissues,  and  withdrawn  a  little 
way.  An  adhesive  strip  may  be  used  to  hold  it  in 
place.  Do  not  become  alarmed  if  a  large  swelling 
occurs.  Persistent  kneading  of  the  tissues  around  this 


2  80  MATERIA  MEDIC  A   FOR  NURSES. 

will  reduce  it.  A  linen  band  may  be  placed  about  the 
patient's  chest  to  prevent  swelling,  but  this  is  un- 
necessary. Twenty  minutes  to  one-half  hour  is  usually 
required  for  500  mils,  to  infiltrate  the  tissues. 

Mercury  is  used  in  the  form  of  the  bichloride,  or  gray 
oil,  and  is  injected  deep  into  the  buttocks,  as  a  rule. 

Ether,  camphor \  ammonia,  alcohol,  and  caffeine  are 
all  injected  into  the  muscles  and  are  so  used  to  obtain 
the  rapid  stimulating  effect  of  the  drugs. 

Digitaline,  ergotine,  and  arsenic  in  the  form  of 
atoxyl,  are  put  in  deep. 

Atropine,  quinine,  nitroglycerin,  pilocarpine,  adren- 
alin, hyoscine,  and  eserine  are  also  used  hypodermically, 
and  may  be  administered  superficially. 

Gelatin  has  been  injected  subcutaneously,  but  its 
use  is  becoming  limited.  Other  drugs  may  be  used 
hypodermically. 

Piqures. 

The  Italians  administer  iron,  arsenic,  and  strych- 
nine, as  well  as  guaiacol  and  other  drugs,  as  tonics  by 
hypodermic  injection,  calling  the  custom  the  giving  of 
*'  piqures."  The  drug  is  prepared  and  hermetically 
sealed  in  a  thin  glass  tube  about  3  cm.  long  and  contain- 
ing 3  mils,  of  the  fluid  ready  to  be  used  in  the  syringe 
after  the  neck  of  the  tube  is  broken  off  by  snipping  it 
with  a  pair  of  scissors.  One  injection  is  given  each  day 
into  the  gluteal  muscles,  on  alternate  sides.  The 
injection  is  administered  deep  as  above  described. 
About  30  minims  or  an  ordinary  syringeful  is  the 
amount  given,  and  the  fluid  is  forced  in  rapidly,  the 
quicker  the  less  painful.  Abscesses  are  not  known  to 
occur  except  through  gross  carelessness  in  technique. 
Strict  asepsis  is,  of  course,  necessary. 


SERUM  THERAPY. 

The  revival  of  an  ancient  principle  of  treatment 
practised  by  Mithridates  in  his  empire  is  of  recent 
occurrence.  We  read  that  "  Mithridates  believed  it 
possible  to  render  himself  proof  against  all  forms  of 
poison  by  the  constant  and  daily  use  of  small  doses  of 
various  poisonous  principles,  and  he  compounded  a 
general  antidote  by  combining  all  forms  of  poison  then 
known.  He  mixed  with  this  the  blood  of  geese  and 
used  the  remedy  for  snake  bite,  reasoning  that  the 
geese  must  have  some  antidote  for  snake  venom  in 
their  blood,  because  one  of  the  chief  articles  of  their 
diet  was  the  viper,  to  whose  bite  they  were  very 
resistant.'*  At  the  present  time  we  use  the  serum 
from  the  blood  of  animals  that  have  been  treated  with 
a  killed  culture  of  bacteria,  or  the  toxins  caused  by 
bacteria,  until  the  animals  become  immune  to  the  kind 
of  bacteria  or  toxins  used.  Khrlich  explains  this  im- 
munity by  his  side-chain  theory.  His  idea  is  that  the 
body  cells  have  groups  of  characteristics  which  may 
link  them  to  certain  substances.  Toxins  contain  two 
groups  of  properties,  the  toxaphore  group,  which  exerts 
its  influence  on  the  body  cells,  and  the  haptophore 
group,  which  combines  the  toxaphore  group  or  toxic 
element  with  the  haptophore  group  in  the  tissue  cells, 
forming  a  side  chain  to  the  cells.  The  haptophore 
groups  of  the  cells  are  destroyed,  but  nature  quickly 
replaces  them,  producing  more  than  were  destroyed, 
the  excess  being  liberated  into  the  blood.  This  excess 
is  called  antitoxin.  The  ai  titoxin  has  an  affinity  for 
the  haptophore  group  in  tb  i  toxin,  and  by  combining 
with  the  latter  in  the  circulation  protects  the  tissue 
cells  by  rendering  the  toxin  inert.  The  injection  of 

281 


282  MATERIA  MEDICA  FOR  NURSES. 

antitoxin  gives  immunity — as  in  tetanus — if  admin- 
istered before  the  toxin  is  introduced  into  the  system, 
or  cures — as  in  diphtheria, — in  some  cases,  if  admin- 
istered after  the  toxin  has  entered  the  system.  This 
is  antitoxic  immunity.  Bactericidal  immunity  is  more 
complex.  When  bacteria  enter  the  body  they  cause 
the  tissue  cells  and  other  cells  to  throw  off  an  immune 
body  (amboceptor)  which  can  destroy  the  bacteria  only 
by  linking  them  to  the  complement  which  is  contained 
in  the  bodies  of  all  beings.  The  immune  body  is  the 
protective  agent.  Much  could  be  hoped  from  bacteri- 
cidal sera  could  they  be  obtained  so  readily  as  anti- 
toxin, but  great  difficulty  has  been  experienced  in 
procuring  such  sera.  We  have  then  two  kinds  of  sera : 
antitoxic,  such  as  antitetanus,  antidiphtheritic,  and 
anticellular;  and  antibacterial,  such  as  antipneumo- 
coccic,  antityphoid,  and  antiplague. 

Classifications  of  Antitoxins,  Serums,    Vaccines,  and 
Extracts. 

A.  Vaccines. 

1.  Cultivations. 

a.  Containing  pathogenic  micro-organisms;   such 
as  anthrax,  one  form  of  cancer  vaccine,  cholera 
vaccine,   Coley's  fluid,   Haffkine's  plague  vac- 
cine,   tuberculin   and  T.  R.  of  Koch,   typhoid 
vaccine  of  Wright. 

b.  Containing  toxins  only;   such  as  one  form  of 
cancer     remedy,      diphtheria     toxin,     mallein, 
tetanus  toxin,  and  tuberculin  Koch  (?). 

2.  a.  Tissues  of  animals  suffering  from  an  infectious 

disease;  such  as  malignant  oedema  and  rabies. 
b.  Fluids  of  animals  suffering  from  an  infective 
disease;  such  as  vaccine  lymph,  and  glycerinated 
calf  lymph. 

B.  Anti-  Serums  —  Anti  iphtheritic   and   Antitetanic 

Serums. 

I.  Antitoxins;  such  as  antipneumonia,  antivenene, 
and  diphtheria  and  tetanus  antitoxins. 


SERUM  THERAPY.  283 

2.  Antibacterial;  such  as  cancer  antibacterial  serum, 
cholera  antibacterial  serum,  antileprosy  serum, 
antitubercular  serum,  antirabic  serum,  anti- 
streptococcic  serum,  antityphoid  serum,  and 
Yersin's  plague  serum. 

C>  Animal  Tissue  Extracts — Organo-  Therapy.  Bone 
marrow,  thyroid  extract,  and  suprarenal  extract 
are  the  chief  of  these. 

(Sims  Woodhead's  Classification.) 

Diphtheria  antitoxin  is  prepared  as  follows:  A 
colony  of  diphtheria  bacilli,  after  being  placed  in  a  suit- 
able medium  and  under  favorable  conditions,  multiply 
with  great  rapidity,  secreting  at  the  same  time  then 
poison  or  toxins.  After  a  few  weeks,  when  sufficient 
of  the  toxin  has  formed,  the  bacilli  are  destroyed  by 
means  of  carbolic  acid,  and  by  filtering  through  porous 
plates  of  clay  the  dead  bacilli  are  removed  from  the 
solution  of  toxins.  Of  this  solution  small  amounts 
are  injected  into  the  blood  of  a  healthy  horse,  produc- 
ing a  mild  attack  of  the  disease;  this  procedure  is  then 
repeated  for  several  months,  the  doses  of  toxin  being 
steadily  increased  until  the  animal  becomes  habituated 
to  the  poison.  Then  a  quantity  of  blood  is  withdrawn 
from  the  animal,  and  the  serum,  or  aqueous  portion, 
is  separated  from  the  red  blood  corpuscles,  this  serum 
constituting  a  light  yellow  liquid  which  contains  the 
antitoxin  of  diphtheria.  The  serum  is  standardized 
by  determining  the  quantity  required  for  injection  to 
neutralize  a  fatal  dose  of  diphtheritic  poison  in  a  guinea- 
pig;  the  ratio  between  the  quantity  of  antitoxin  and 
the  body  weight  of  the  animal  furnishes  a  means  of 
indicating  in  definite  units  the  strength  of  the  solution. 

Behring" 's. — No.  i  equals  600  immunizing  units;  No. 
2,  1000;  No.  3,  1500.  In  j  oz.  vials,  varying  measure 
but  full  unit  value. 

Gibier's  (N.  Y.  Pasteur  Institute).— Identical  with 
Roux's.  Immunizing  power,  1:100,000 — i.  e.,  \  mil, 
prophylactic  up  to  no  pounds ;  regular  treatment, 
5-15  mils  a  day. 


284  MATERIA  MEDIC  A  FOR  NURSES. 

Roux*s. — Same  description  as  Gibier's. 

Schering-Aronson — Supplied  in  vials  containing  5 
mils,  equivalent  to  500  antitoxic  normal  units, 

Bvery  case  of  diphtheria  should  be  treated  with  the 
antitoxin  as  early  as  possible,  3000  units  being  an 
average  first  dose.  All  persons  exposed  should  be 
given  an  immunizing  dose  of  500  units,  except  children 
under  two  years,  with  whom  300  units  is  sufficient, 
repeating  the  dose  every  three  weeks  in  any  case,  until 
all  danger  is  past.  The  antitoxin  is  used  as  directed 
under  "  Hypodermics." 

Rabies  Antitoxin,  for  Plydrophobia.  — Pasteur  founded 
the  system  of  treating  rabies  by  the  injection  of  an 
emulsion  of  the  spinal  cord,  believed  to  contain  the 
poison,  no  bacilli  being  yet  found.  The  rabies  poison 
having  a  special  affinity  for  the  spinal  cord,  rabbits  are 
inoculated  with  poison  obtained  from  sections  of  the 
spinal  cord  at  different  stages  of  treatment.  In  the  end 
an  immunity  is  set  up  in  the  animals;  an  anti-rabic 
virus  is  obtained  and  injected  into  persons  bitten  by 
mad  dogs.  Pasteur  Institutes,  where  treatment  is  pro- 
vided for  those  bitten  by  animals,  are  located  at  con- 
venient points  throughout  the  United  States.  The 
treatment  costs  about  one  hundred  dollars. 

Tetanus  Antitoxin  has  not  proved  satisfactory  as  a 
curative  agent,  but  has  been  of  some  benefit,  and  is 
very  effective  as  a  prophylactic.  Its  method  of  prep- 
aration is  analogous  to  that  of  diphtheria  antitoxin, 
and  it  is  similar  to  this  in  nature  and  action.  The 
U.  S.  P.  recognizes  the  tetanus  antitoxin,  Serum  An- 
titctanicum,  and  also  the  refined  concentrated  serum 
and  the  dry  form.  The  average  dose  is:  hypodermic, 
10.000  units,  protective,  1500  units.  The  dry  antitoxin 
is  designated  as  a  hundred-fold  normal  antitoxin — z.  e., 
i  Gm.  is  sufficient  to  neutralize  100  Gm.  of  the  normal 
poison  of  tetanus.  It  is  put  up  in  5  Gm.  vials,  this  quan- 
tity being  theoretically  sufficient  to  effect  a  cure.  The 
vialful  is  dissolved  in  30  mils  of  sterilized  water  at  40°  C., 
and  injected  hypodermically  at  a  single  dose.  The  liq- 
uid form  is  of  fivefold  normal  strength,  and  is  employed 


SERUM  THERAPY.  285 

hypodermically  in  cases  of  wounds  where  there  is 
reason  to  fear  development  of  tetanus,  in  quantity 
proportionate  to  the  condition  of  the  patient  and  the 
length  of  time  elapsed  since  the  injury.  The  antitoxin 
should  not  be  kept  long  because  it  spoils  readily.  It 
should  be  injected  in  the  same  way  as  diphtheria  anti- 
toxin. Large  doses  used  thoroughly  will  influence 
many  cases  of  tetanus  favorably  if  anything  will. 

Antityphoid  Serum  is  prepared  in  much  the  same 
way  that  the  antitoxins  are  prepared,  but  the  im- 
munizing period  in  the  horse  is  much  longer,  being 
about  one  year.  In  cases  of  typhoid  fever  the  Chante- 
messe  serum  is  injected  into  the  flexor  surface  of  the 
elbow,  about  the  plexus  of  large  veins,  in  doses  of  8-10 
mils,  and  in  a  week,  if  the  fever  persists,  4-10  mils  are 
again  injected.  A  prophylactic  dose  of  2  mils  may  be 
used  for  those  exposed  to  the  disease. 

Antiplague  Serum  made  by  Yersin  has  proved  of 
value  in  treating  the  bubonic  plague.  It  is  given  in 
doses  of  150-300  mils. 

Tubercular  Serum  (Behring,  Koch,  Fisch,  or  Mara- 
gliano)  is  used  in  the  treatment  of  early  cases  of 
tuberculosis  where  there  is  no  mixed  infection,  in  a 
gradually  increasing  dose  of  0.2-2  mils  over  a  period 
of  two  years.  Tuberculin  (Koch),  prepared  by  extrac- 
tion of  pure  cultures  of  tubercle  bacilli  with  40-50  <f> 
glycerin  and  repeated  precipitation  with  alcohol,  as  a 
snow-white  mass  soluble  and  stable  in  50  %  glycerin, 
is  used  in  the  diagnosis  of  local  and  pulmonary  tuber- 
culosis. The  characteristic  reaction  to  an  injection  of 
tuberculin  shows  itself  locally  by  increased  heat  and 
systemically  by  a  rise  in  temperature,  usually  in  12 
hours.  It  is  injected  between  the  shoulder-blades  at 
night  in  doses  of-do—h  gr.,  i-i  mil. 


Vaccine  Virus.  —  This  comes  in  small  sealed  glass 
tubes  in  sterile  form  and  is  the  official  lymph  for  vac- 
cination. Only  such  vaccine  virus  may  be  sold  as  has 
been  made  in  places  licensed  by  the  Secretary  of  the 
Treasury  of  the  U.  S.  The  tubes  may  be  large  or 


286  MATERIA   MEDIC  A    FOR  NURSES. 

small  and  will  vaccinate  from  2  to  80  persons,  depend- 
ing upon  the  size  of  the  tuba  used. 

Antivenene  (s/rum  antiv£n£neux,  Calmette)  is  pre- 
pared from  the  blood  of  asses  and  horses  which  have 
been  immunized  against  snake  poison.  The  power  of 
immunization  is  i  in  10,000.  It  should  be  carried  by 
all  persons  going  to  a  district  infested  with  snakes, 
especially  in  India.  The  dose  for  adults  is  20  mils; 
for  children,  10  mils;  in  very  dangerous  cases  the  dose 
is  doubled. 

Antistreptococcus  and  Antipneumococcus  sera  have  not 
proved  to  be  distinctly  valuable,  although  the  former 
may  do  good,  and  can  do  no  harm  in  general  infections, 
erysipelas,  and  scarlet- fever.  I^arge  and  frequent  doses 
are  required. 

Many  other  sera  have  been  exploited,  among  them 
anticholera,  antidysentery,  antiscarlatina,  and  those  for 
the  cure  of  yellow  fever,  anthrax,  glanders,  leprosy, 
whooping-cough,  erysipelas,  syphilis,  malaria,  and  hay- 
fever,  but  none  of  these  has  yet  proved  of  marked 
practical  value. 

Red  Bone  Marrow  Extract.  —The  marrow  of  ox-bone 
and  sheep-ribs  has  been  used  as  a  remedy  for  chronic 
debilitating  blood  diseases.  It  comes  in  the  form  of 
tablets  containing  one  grain  of  the  desiccated  marrow, 
equal  to  twenty  grains  of  the  substance  in  its  natural 
state.  Each  tablet  weighs  three  grains.  Dose,  1-3 
tablets. 

Dried  Supra*  enals. — This  is  now  an  official  product, 
as  given  on  page  268. 

The  active  principle  of  the  gland,  epinephrin,  has 
been  isolated  by  Abel  and  Crawford,  but  it  is  not  used 
in  therapeutics.  The  dried  extracts  of  the  whole  gland, 
or  a  liquid  extract,  or  adrenalin  may  be  used.  These 
preparations  are  notable  for  causing  contraction  of 
small  blood-vessels  when  applied  locally,  blanching 
the  skin  or  mucous  membrane,  and  for  a  general  tonic 
effect  on  the  heart  and  arteries  when  given  internally. 


SERUM  THERAPY.  287 

They  strengthen  the  heart's  action  and  slow  and  regu- 
late the  pulse,  causing  a  rapid  rise  in  blood  pressure. 

Adrenalin  Chloride  Solution.     Not  official. 

Average  dose,  TTJ,  xv.-i  mil  by  the  mouth.  Diluted 
with  normal  salt  solution  ten  times  it  is  used  as  a 
hypodermic  injection,  and  has  been  suggested  for  in- 
travenous injection.  It  is  injected  with  cocaine  and 
eucaine  to  cause  anaesthesia  and  bloodless  operations. 
For  spray  inhalations  the  strength  of  i  to  2500  or  i  to 
5000  is  effective.  The  solution  is  easily  oxidizable  and 
should  be  kept  closely  stoppered  and  away  from  the 
light. 


ELECTRO-THERAPEUTICS    AND 
RADIOLOGY 

The  use  of  electricity  as  a  therapeutic  agent  in  dis> 
ease  requires  special  training  and  study  and  should  not 
be  attempted  by  an  unskilled  person.  It  is  desirable, 
however,  that  nurses  should  be  cognizant  of  the  various 
forms  such  treatment  may  take  in  order  that  they  may 
intelligently  prepare  their  patients  for  such  treatment 
and  if  necessary  assist  in  administering  it. 

It  would  be  impossible  within  the  limits  of  a  brief 
chapter  to  do  more  than  indicate  the  various  phases 
of  such  a  far-reaching  subject.  The  aim  of  the  accom- 
panying outline,  therefore,  is  to  emphasize,  for  the 
benefit  of  the  nurse  in  general  practice,  a  few  practical 
points  commonly  overlooked,  and  to  serve  as  a  point  of 
departure  for  those  desiring  to  make  further  study  of 
the  subject. 

Among  the  more  common  types  of  electric  cur- 
rent used  for  therapeutic  purposes  are  the  following: 
Galvanism,  faradism,  the  static  and  high-frequency 
currents. 

Galvanism. 

This  form  of  current  is  commonly  applied  by  means 
of  two  moistened  electrodes  attached  to  the  storage 
cells  of  a  battery.  This  current  is  continuous  and  its 
application  is  therefore  usually  painless,  except  at  the 
time  of  the  "make"  and  "break"— i.  e.,  at  the  time  of 
the  application  of  the  electrodes  and  of  their  removal. 
Movement  of  the  electrodes  from  one  point  to  another 
on  the  skin  should  be  effected  by  sliding  them  along  the 

288 


ELECTRO-THERAPEUTICS  AND  RADIOLOGY.     289 

surface  of  the  body  and  not  by  abruptly  removing  them 
from  one  spot  and  applying  them  to  another,  thus 
avoiding  the  production  of  a  somewhat  painful  electric 
shock.  The  current  should  be  turned  on  gently  at 
first  and  increased  in  strength  as  the  treatment  pro- 
gresses, and  at  the  termination  of  the  treatment  it  should 
gradually  be  lessened  in  strength  and  not  abruptly  shut 
off.  The  apparatus  is  simple  and  its  detail  can  easily 
be  mastered  by  a  careful  study  of  the  switches  and  of 
the  rheostat— a  device  for  regulating  current.  The 
application  of  this  form  of  electrical  treatment  will 
frequently  be  left  to  the  nurse  and  it  would  be  advisable 
for  her  to  experiment  upon  herself  with  the  electrodes 
before  applying  them  to  her  patient,  thereby  familiariz- 
ing hereself  with  the  sensations  likely  to  be  produced 
by  the  current  at  various  strengths. 

Uses. 

The  galvanic  current  is  employed  in  the  treatment 
of  paralyzed  muscles  to  improve  their  nutrition  by 
means  of  the  improved  blood  supply,  which  is  one  of 
the  effects  of  the  current,  and  to  directly  stimulate  the 
muscle  cells  themselves,  upon  which  the  current  has  a 
marked  effect. 

Faradism. 

In  this  case  the  electric  current  is  passed  through  an 
induction  coil  and  an  interrupter  which  "  makes  and 
breaks ' '  the  current.  Its  application  is  therefore  some- 
what more  painful  than  that  of  galvanism.  Its  mode 
of  application  is  similar  and  portable  batteries  usually 
provide  for  the  production  of  both  kinds  of  current. 

Uses. 

Its  chief  use  also  consists  in  its  beneficial  influence 
on  paralyzed  muscle. 
19 


2QO  MATERIA  MEDIC  A  FOR  NURSES. 

Static  and  High-Frequency  Currents. 

These  are  both  produced  by  complicated  apparatus 
and  are  forms  of  high-potential  electricity  which  can 
be  safely  administered  only  by  an  expert.  A  nurse's 
duty  will  consist  in  preparing  a  patient  for  such  treat- 
ment by  seeing  that  she  is  appropriately  dressed  in 
loose  warm  clothing,  free  from  all  metal  such  as  hair 
pins,  brooches,  safety  pins,  etc.,  which  tend  to  "spark  " 
and  alarm  the  patient  unnecessarily. 

Uses. 

The  high-frequency  current  is  widely  employed  in 
various  conditions.  Its  most  marked  therapeutic  ac- 
tions seem  to  be  in  the  reduction  of  blood  pressure, 
relief  of  neuralgic  pain,  and  in  conditions  where  absorp- 
tion of  inflammatory  conditions  is  required,  as  in  eczema, 
lupus,  and  acne. 

The  X-Rays. 

In  1895  Professor  Roentgen  discovered  the  existence 
of  X-rays  during  the  course  of  an  experiment  with 
cathode  rays  which  had  previously  been  discovered  by 
Crookes,  an  English  observer,  in  1849.  The  X-rays, 
though  invisible  to  the  eye,  have  the  property  of  pene- 
trating solid  substances  to  a  considerable  degree  and 
are  capable  of  affecting  a  photographic  plate.  The 
value  of  such  a  discovery  to  surgical  and  medical  diag- 
nosis is  at  once  apparent.  By  these  rays  fractures  can 
be  accurately  portrayed,  foreign  substances  located,  and 
many  obscure  conditions  cleared  up. 

Preparation  of  a  patient  for  X-ray  examination  con- 
sists in  the  removal  of  metal  splints,  pins,  and  adhesive 
plaster  from  the  area  to  be  examined,  as  these  sub- 
stances are  more  or  less  opaque  to  the  rays  and  will  cast 
confusing  shadows  on  the  photographic  plate,  thereby 
impairing  its  usefulness.  If  a  wound  exists  in  the  field, 
any  bismuth  or  iodoform  dressing  must  be  removed, 
since  these  substances  also  are  non-permeable. 


ELECTRO-THERAPEUTICS  AND  RADIOLOGY. 

For  diagnostic  purposes,  it  is  frequently  desirable  to 
radiograph  the  stomach  or  intestine.  Since  these  organs 
are  more  or  less  permeable  to  the  rays,  it  is  necessary 
that  some  metallic  substance,  such  as  bismuth,  be  in- 
gested shortly  before  the  exposure  is  made,  in  order 
that  the  outline  of  the  organs  may  be  more  clearly  de- 
fined. Some  cereal  mixed  with  bismuth  is  frequently 
employed  for  this  purpose.  In  searching  for  calculus 
in  the  kidneys,  ureters,  or  gall-bladder,  it  is  highly  im- 
portant that  the  colon  should  be  empty  and  that  a  large 
meal  be  not  taken  for  some  hours  prior  to  exposure.  A 
cathartic  is  frequently  administered  the  previous  day 
and  a  cleansing  enema  given,  so  as  to  avoid  the  possi- 
bility of  the  presence  of  foecal  masses,  which  will 
seriously  obscure  the  plate. 

Therapeutic  Action  of  X- Rays. 

The  X-rays  have  been  found  to  have  a  marked 
curative  effect  on  some  forms  of  lupus,  eczema,  and 
epithelioma.  It  is  sometimes  desired  to  push  their  use 
until  a  reaction  occurs,  known  as  an  X-ray  burn,  and 
it  is  necessary  that  a  nurse  should  be  able  to  recognize 
the  symptoms  of  such  reaction,  which  may  be  delayed 
and  may  not  appear  for  days  or  even  weeks  after  the 
exposure  has  been  made.  It  is  characterized  by 
marked  reddening  of  the  part  exposed,  accompanied  by 
some  pain  and  slight  swelling.  If  the  * '  burn ' '  be  not 
severe,  the  redness  disappears  in  a  few  days  and  the 
part  desquamates.  In  severe  cases  the  condition  goes 
on  to  vesication  and  even  to  severe  sloughing  and  de- 
struction of  the  tissue  accompanied  by  agonizing  pain. 

It  should  be  remembered  that  some  persons  exhibit  a 
marked  idiosyncrasy  to  the  rays  and  will  develop  a  burn 
after  a  few  seconds'  exposure  for radiographic  purposes. 
The  main  points  to  be  remembered  are  that  the  reaction 
is  never  apparent  at  the  time  and  may  be  considerably 
delayed,  and  that  any  reddening  of  the  part  is  a  danger 
signal  that  should  not  be  overlooked  so  that  it  may 
be  immediately  reported  and  appropriate  treatment 
instituted. 


292  MATERIA  MEDIC  A  FOR  NURSES. 

Radium. 

The  use  of  this  substance  as  a  therapeutic  agent  is 
still  in  the  experimental  stages.  Its  existence  was 
first  demonstrated  by  the  Curies  in  Prance  in  1898,  and 
was  proven  to  be  radio-active,  /.  e.,  to  have  the  power  of 
emitting  rays  without  relation  to  the  sun  or  other  ex- 
ternal conditions.  Experiments  are  being  made  as  to 
its  effects  on  the  physiological  processes  of  the  body. 
It  is  known  that  it  causes  the  blood-vessels  to  dilate,  is 
possibly  bacteriacidal,  has  some  electrical  action,  and 
influences  quickly  growing  tissues  such  as  cancerous 
growth.  Its  future  as  a  remedial  agent  in  these  con- 
ditions remains  to  be  determined. 


MINERAL  WATERS. 

Aix-les-Bains  (Savoy)  contains  sulphur  and  a  curi- 
ous organic  matter  called  Bar£gine,  which  renders  it 
easy  of  digestion,  oily,  and  suitable  for  massage.  It 
is  anti-rheumatic  in  action.  The  resort  is  open  nearly 
all  the  year;  the  season  of  greatest  benefit  is  from  April 
ist  to  November  ist. 

Aix-la-Chapelle  (Aachen,  Prussia)  is  a  sulphurous 
saline  water  containing  sodium  chloride,  sodium  bicar- 
bonate, sodium  and  potassium  sulphates,  sulphuretted 
hydrogen,  and  carbonic  acid.  The  water  may  be 
imported,  and  is  drunk  or  used  for  baths.  The  two 
seasons  extend  from  May  i5th  to  September  3oth,  and 
from  September  15th  to  March  3 ist. 

Alexanderbad  (Bavaria)  is  a  chalybeate  water  con- 
taining iron  and  manganese.  The  season  extends 
from  May  isth  to  October  ist. 

Alexisbad  (Germany)  has  three  springs  of  chaly- 
beate water:  Alexisbrunnen,  Schonheitsquelle,  and 
Stahlbrunnen  or  Grotte.  Open  from  May  2Oth  to 
September  2oth.  The  water  contains  iron,  manganese, 
potassium  chloride,  and  free  carbonic  acid. 

Allevard  (Is&re,  France)  is  a  carbonated  sulphurous 
water  containing  calcium  and  magnesium  bicarbonates, 
sodium  chloride,  calcium,  sodium,  and  magnesium  sul- 
phates, free  sulphuretted  hydrogen,  carbonic  acid,  and 
nitrogen.  The  water  may  be  imported  and  the  season 
at  the  spring  is  from  June  ist  to  September  ist. 

Apenta  (near  Budapesth)  is  an  aperient  water  con- 
taining magnesium,  sodium,  and  calcium  sulphates, 
sodium  chloride,  with  small  quantites  of  lithium  and 
potassium  sulphates.  It  is  imported. 

Apollinaris  (Neuenahr,  Germany)  is  a  stable  acidu- 
333 


294  MATERIA  MEDICA  FOR  NURSES. 

lated  alkaline  water  and  contains  sodium  chloride, 
calcium  and  magnesium  bicarbonates,  with  a  large 
excess  of  carbonic  acid.  It  is  imported. 

Arabella  (Hungary)  is  a  saline  aperient  water  used 
as  a  mild  purgative  and  contains  magnesium  and 
sodium  sulphates  similar  to  Apenta.  It  is  imported. 

Baden-Baden  (Germany)  is  a  lithiated  arsenical 
water.  The  season  at  the  springs  is  summer,  and  the 
water  is  imported. 

Baden  (near  Vienna)  is  a  sulphurous  water  contain- 
ing calcium  and  sodium  sulphates.  It  rises  warm  and 
has  in  it  free  carbonic  acid.  The  place  is  open  through- 
out the  year. 

Bath  (Somersetshire). — The  only  true  thermal  water 
in  England.  Saline,  21  grains  in  20  oz.  Chiefly 
calcium  sulphate  and  small  quantities  of  sodium  sul- 
phate and  magnesium  chloride,  with  carbonic  acid 
gas  and  nitrogen.  Several  baths  varying  in  temper- 
ature from  88°  to  120°  F.  (31.1°  to  48.8°  C.).  For 
chronic  rheumatism,  gout,  and  paralysis.  The  water 
is  aerated  and  sold  in  bottles  under  the  name  of  Sulis 
Water.  Radium  has  been  discovered  in  the  waters  of 
Bath  and  Buxton. 

Bethesda  (Wisconsin,  U.  S.  A.)  is  an  alkaline  water 
which  is  bottled  for  use.  It  contains  calcium  and 
magnesium  bicarbonates. 

Buda-Pesth^  St.  Lucasbad  (Hungary)  is  a  warm  sul- 
phurous water  which  contains  potassium,  sodium,  and 
calcium  sulphates  and  sulphuretted  hydrogen.  It  is 
used  for  bathing  (sulphur  mud  baths)  and  the  hot 
water  is  taken  internally.  The  place  is  frequented  all 
the  year. 

Buffalo  Lithia  (Mecklenburg  Co.,  Va.,  U.  S.  A.)  is 
an  alkaline  lithiated  table  water.  There  are  three 
springs,  of  which  No.  2  is  the  chief.  The  water  con- 
tains calcium  bicarbonate  and  sulphate,  carbonic  acid, 
and  sulphuretted  hydrogen.  The  place  is  open  from 
June  1 5th  to  October  ist,  or  the  water  may  be  obtained 
bottled. 

Buxton  (Derbyshire)  is  a  slightly  saline  water  con- 


MINERAL  WATERS.  295 

taining  sodium  chloride,  magnesium  carbonate,  cal- 
cium carbonate,  free  nitrogen,  and  carbonic  acid.  The 
place  is  open  all  the  year  round  or  the  water  may  be 
bottled. 

Carlsbad  (Bohemia)  is  a  lithiated  alkaline  water  from 
a  number  of  springs  practically  all  the  same;  that 
known  as  Sprudel  is  the  most  important.  The  water 
contains  sodium  bicarbonate,  sulphate,  and  chloride, 
lithium  and  calcium  bicarbonates,  and  carbonic  acid. 
Season  all  the  year  round,  principally  in  July.  The 
water  may  be  imported.  Carlsbad  Sprudel  Salts  (dry 
and  crystals)  are  also  supplied. 

Condillac  (France)  is  an  imported  alkaline  acidulated 
table  water. 

Driburg  (Westphalia)  is  a  chalybeate,  tonic,  aperient 
water  containing  sodium  sulphate,  magnesium  sul- 
phate, bicarbonate  of  calcium  and  magnesium,  some 
iron  and  magnanese,  and  carbonic  acid.  Season  from 
May  ist  to  October  loth,  or  the  water  may  be  imported. 

Eaux  Bonnes  (Basses-Pyrenees,  France)  is  a  mild 
sulphurous  water  similar  to  Bareges  and  Cauterets.  It 
contains  sodium  sulphate  and  chloride,  calcium  sul- 
phate, and  sulphuretted  hydrogen.  Principal  season 
from  June  ist  to  October  ist,  or  the  water  may  be 
imported. 

Ems-Bad  (Germany)  is  an  alkaline  saline  water  that 
rises  warm  and  contains  sodium,  calcium,  and  mag- 
nesium bicarbonates,  sodium  chloride,  and  free  car- 
bonic acid.  Season  May  ist  to  September  3oth,  or  the 
water  may  be  imported. 

Fontalis  is  a  pure  alkaline  table  water,  aerated  and 
bottled  at  Harrogate.  It  contains  chlorides  and 
carbonates  free  from  lime  and  magnesium  salts. 

Friedrichshall  (Saxe-Meiningen,  Germany)  is  an 
active  diuretic  and  aperient  water  that  is  imported.  It 
contains  magnesium  and  sodium  sulphates,  sodium 
chloride,  and  magnesium  chloride. 

Harrogate  (Yorkshire)  is  a  sulphurous  water  con- 
taining sodium  sulphate,  sodium,  magnesium,  and 
calcium  chlorides,  calcium  carbonate,  magnesium 


296  MATERIA  MEDICA   FOR  NURSES. 

bromide,  and  sulphuretted  hydrogen.  It  possesses 
aperient  and  diuretic  properties.  The  season  is  sum- 
mer and  winter  or  the  water  may  be  had  in  bottles. 

Hunyadi  Jands  (Buda-Pesth)  is  an  imported  aperi- 
ent water  containing  large  percentages  of  magnesium 
and  sodium  sulphates,  sodium  chloride,  and  sodium 
and  calcium  bicarbonates. 

Kissingen  (Bavaria,  Germany),  Rakoczy  and  Pauden 
springs,  is  a  saline  aperient  water  containing  sodium 
and  potassium  chlorides,  and  iron  and  calcium 
bicarbonates.  It  is  imported. 

Kissingen  (Bavaria)  Bitter  Water  is  an  aperient  con- 
taining magnesium  and  sodium  sulphates  and  carbonic 
acid. 

Leamington  is  a  bottled  saline  water  containing  sod- 
ium, magnesium,  and  calcium  sulphates,  sodium,  cal- 
cium, and  magnesium  chlorides,  and  ferrous  carbonate. 

Malvern  (Worcestershire)  is  a  bottled  water  practi- 
cally free  from  saline  matter,  and  contains  no  organic 
matter. 

Marienbad  (Bohemia).  There  are  several  springs, 
alkaline,  saline,  chalybeate,  and  acidulated.  The 
waters  contain  sodium  sulphate,  chloride,  bicarbonates 
of  alkaline  earth  metals,  ferrous  iron,  and  free  carbonic 
acid.  It  is  supplied  in  powder  or  crystals,  and  tablets 
are  also  made.  The  season  is  summer,  or  the  water 
may  be  imported. 

Nauheim  (Germany)  is  a  chalybeate  iron  and  lithia 
water  used  in  skin  and  rheumatic  affections  and  heart 
diseases. 

Nordhall  (Lincolnshire)  is  a  bromo-iodized  water 
containing  bromine,  iodine,  sodium  chloride,  and 
arsenic.  The  place  is  open  from  March  3ist  to 
October  3ist. 

Salutaris  is  pure  distilled  water,  still  or  aerated,  for 
table  use. 

Saratoga  (U.  S.  A.)  is  an  alkaline  saline  water  from 
the  "  Congress"  or  "  Hathorn  "  springs.  It  contains 
sodium  chloride  and  iodide,  bicarbonates  of  calcium 
and  magnesium,  and  free  carbonic  acid.  It  is  a  mild 


MINERAL  WATERS.  297 

aperient.  The  place  is  open  all  the  year  round,  or  the 
water  may  be  obtained  in  bottles. 

Sellers,  or  Seltzer  Water  (on  the  Lahn,  Nassau), 
Ober  and  Nieder  springs,  is  an  alkaline  acidulated 
table  water  containing  sodium  chloride,  bicarbonates, 
and  carbonic  acid.  It  is  imported. 

Spa  (Belgium)  is  an  imported  ferruginous  water 
containing  ferrous  bicarbonate  and  free  carbonic  acid. 
The  season  is  summer. 

Suits  (Bath  Water,  aerated)  is  an  aperient  table 
water  containing  calcium  and  sodium  sulphates,  mag- 
nesium, and  sodium  chloride. 

Vichy  (Allier,  France)  is  an  imported  alkaline,  acid- 
ulated water  from  one  of  the  springs:  Grande-Grille, 
H6pital,  Celestins,  or  Pare.  The  place  is  open  from 
May  1 5th  to  September  3oth. 

Wiesbader  (Nassau)  Kochbrunnen  is  an  antacid 
water  couta^.'ng  sodium  and  potassium  chlorides, 
magnesium  and  sodium  bicarbonates,  and  free  car- 
bonic acid.  The  place  is  open  all  the  summer  or  the 
water  may  be  imported. 


UNCLASSIFIED  DRUGS  (ALPHABETICALL  Y 
ARRANGED). 

Acetalis  a  derivative  of  alcohol,  employed  as  a  seda- 
tive and  hypnotic.  It  is  usually  given  as  an  emulsion. 

Average  dose,  3  i.~4  mils. 

Acetone  (official)  is  prepared  by  the  dry  distillation 
of  calcium  acetate.  It  is  a  colorless  liquid  with  a 
peculiar  ethereal  odor,  and  sharp,  biting  taste.  Mis- 
cible  with  water,  alcohol,  and  ether.  Employed  as  a 
nervine,  as  an  intestinal  antiseptic  and  anthelmintic. 

Acetozone  is  a  proprietary  form  of  benzoyl-acetyl 
peroxide,  and  is  used  as  an  intestinal  antiseptic  and 
antipyretic. 

Airol  (bismuth  oxy-iodo-gallate),  or  dermatol  oxi- 
dized with  the  addition  of  iodine,  forms  a  greenish  gray, 
fine,  voluminous,  inodorous,  and  tasteless  powder. 
Moisture  causes  it  to  turn  red  with  loss  of  iodine. 
Soluble  in  dilute  acids  and  alkalies.  Used  as  a  dusting 
powder  in  place  of  iodoform. 

Albolene,  a  refined  product  of  petroleum  that  cannot 
become  rancid.  Used  as  a  basis  for  ointments. 
Albolene  liquid  is  a  colorless,  odorless,  tasteless  fluid, 
very  light  and  diffusible.  Used  as  a  solvent  for  drugs 
in  oleaginous  solution  for  sprays. 

Analgen  is  a  remedy  used  as  an  antineuralgic,  anti- 
pyretic, and  analgesic. 

Average  dose,  gr.  viii.-o.5  Gm.,  repeated  in  three 
hours. 

Anesthol  is  an  anaesthetic,  composed  of  chloroform, 
ether,  and  ethyl  chloride  in  the  proportions  respec- 
tively of  i,  2,  3,  which  corresponds  closely  to  the  A.  C. 
E.  mixture. 


UNCLASSIFIED  DRUGS.  299 

Antinervin  contains  ammonium  bromide,  salicylic 
acid,  and  acetanilid.  It  is  used  as  an  anodyne  and 
antineuralgic. 

Average  dose,  gr.  viii.-o.5  Gm. 

Apiol  is  a  steroptene  derived  from  garden  parsley. 
Apioline  is  claimed  to  be  the  true  active  principle  of 
parsley.  Each  acts  as  a  stimulating  emmenagogue. 
Average  dose,  fU  v.-o.3  mil.  Continued  use  may  bring 
on  headache,  giddiness,  ringing  in  the  ears,  and  mild 
intoxication.  The  U.  S-  P.  admits  the  oleoresin. 

Apocodein  hydrochloride  is  an  amorphous  yellowish 
powder  used  as  an  expectorant.  Hypodermic  dose, 
gr.  i.-o.o6  Gm. 

Argyrol  is  a  combination  of  silver  with  the  yolk  of 
eggs,  containing  30  %  of  silver.  It  is  used  as  an 
antiseptic  in  inflammatory  affections  of  the  mucous 
membranes.  Solution  5-20  %. 

Aristol  (Annidalin). — The  essential  constituent  of 
aristol  is  iodine,  of  which  it  contains  about  45  $,  other 
substances  entering  into  its  composition  being  thymol 
and  sodium.  It  is  odorless,  and  is  used  as  a  sub- 
stitute for  iodoform.  As  an  antiseptic  it  is  not  strong 
and  has  no  poisonous  qualities.  It  is  used  in  dusting 
powders,  ointments,  and  solutions  in  oil,  ether,  or 
collodion,  usually  in  a  strength  of  from  5-10  %. 

Asaprol  has  analgesic  properties.  It  also  checks 
hemorrhage,  lowers  temperature,  and  lessens  nervous- 
ness and  insomnia.  It  increases  the  amount  of  urine, 
and  sometimes  gives  rise  to  profuse  perspiration.  In- 
ternally gr.  V.-0-3  Gm.  may  be  given  in  a  day.  It  is 
soluble  in  water  and  in  alcohol,  and  is  incompatible 
with  quinine,  iodide  of  potassium,  and  the  soluble  sul- 
phates. For  lotions  or  irrigation  it  is  prepared  in  a 
strength  of  1-5%. 

Asparagin  is  a  derivative  of  marshmallow  root  and 
is  also  contained  in  asparagus.  It  is  used  as  a  diuretic. 
Average  dose,  gr.  ss.-o.o3  Gm. 

Aspirin. — Compound  made  chemically  from  salicylic 
acid.  Action  similar  to  that  of  sodium  salicylate,  but 
more  lasting. 

Average  dose,  gr.  viii.-o.5  Gm. 


300  MATERIA  MEDIC  A  FOR  NURSES. 

Atoxyl  is  an  amido-benzene  compound  of  arsenic, 
administered  in  the  form  of  a  hypodermic  in  place  of 
arsenic  by  mouth. 

Bebeerin,  an  alkaloid  in  the  form  of  a  white  amor- 
phous powder  with  a  bitter  taste,  used  as  a  substitute 
for  quinine.  Average  dose,  gr.  ss.-o.O3  Gm. 

Benzonaphthol  is  a  white,  crystalline  powder,  used  as 
an  intestinal  antiseptic  and  disinfectant.  Average  dose, 
gr.  v.— 0.3  Gm. 

Benzosol  is  a  compound  of  guaiacol.  A  colorless, 
inodorous,  tasteless  powder,  insoluble  in  water.  It 
contains  about  50%  of  guaiacol. 

Average  dose,  gr.  v.-o.3  Gm. 

Betol  or  Naphthalol  is  a  compound  analogous  to  salol, 
but  containing  10  %  less  of  salicylic  acid,  and  being 
correspondingly  less  active  and  less  effective.  In  the 
intestines  it  decomposes  into  naphthol  and  salicylic  acid. 
It  is  used  in  the  same  way  as  salol.  It  is  best  given  in 
pill  or  emulsion. 

Average  dose,  gr.  iii.-o.2  Gm. 

Bismuton  is  a  canary-yellow  powder  containing 
bismuth,  resorcin,  and  tannin.  Average  dose,  gr.  viii.- 
0.5  Gm. 

Bismutose  is  a  fine  greenish  yellow  powder,  with 
astringent  taste,  odorless  and  insoluble.  It  contains 
22%  bismuth  in  albumin  and  sodium  chloride.  Used 
as  an  antacid  and  antidiarrhoea  remedy.  It  acts  more 
quickly  than  other  bismuth  compounds  but  is  more 
constipating.  Average  dose,  gr.  xv.-i  Gm. 

Boro-salicylate  of  Glycerin  is  a  compound  of  boric 
and  salicylic  acids  in  concentrated  form  in  which  all 
their  antiseptic  and  microbicide  powers  are  retained, 
and  is  miscible  with  water  in  all  proportions.  Five 
mils  of  the  compound  contains  i  Gm.  each  of  salicylic 
and  boric  acids. 

Bromal  Hydrate  is  made  by  the  action  of  bromine 
on  alcohol.  It  is  similar  to  chloral  hydrate  in  its 
actions,  being  antispasmodic  and  hypnotic,  but  is 
more  powerful  than  chloral  and  more  direct  and  dan- 
gerous in  its  influence  over  cardiac  muscle.  Large 


UNCLASSIFIED  DRUGS.  301 

quantities  may  cause  death,  preceded  by  anaesthesia 
and  convulsions. 

Average  dose,  gr.  iss.-i  Gm. 

Bromidia  is  said  to  contain  potassium  bromide  and 
chloral-hydrate,  of  each  30  parts;  extract  of  hyos- 
cyatnus  and  extract  of  cannabis  indica,  of  each  0.25 
parts ;  fluid  extract  of  liquorice,  90  parts;  and  oil  of 
orange  peel,  5  drops. 

Brominol,  Bromipin,  is  a  substitute  for  the  bromides 
in  the  form  of  bromine  10  %  in  sesame  oil,  in  which  the 
properties  of  bromine  are  retained  without  any  taste 
or  odor  of  it  or  the  resulting  rash  or  depression  after 
large  doses.  Average  dose,  3  iss.-6  Gm. 

Bromocoll  is  a  combination  of  bromine,  tannin,  and 
gelatin,  containing  20%  of  bromine  and  used  as  a 
substitute  for  the  bromides. 

Bromoformum  (official)  (Bromoform)  is  an  analogue 
of  chloroform,  and  contains  bromine.  It  is  soluble  in 
alcohol;  only  slightly  so  in  water.  It  is  quite  powerful 
in  its  actions,  which  are  antispasmodic,  analgesic,  and 
antiseptic.  Average  dose,  TTJ,.  iii.-o.2  mil. 

Cacodyl  (Arsenic]  Derivatives. — Cacodylic  acid  and 
sodium  cacodylate  and  their  combinations  with 
mercury  have  been  used  extensively  in  anaemic  and 
cachectic  conditions,  internally  and  as  a  lotion  for 
the  eyes  or  for  sores  elsewhere.  Average  dose,  gr. 
i.-o.o6  Gm.,  hypodermically.  Sodium  cacodylate  is 
official. 

Cetrarin  is  a  bitter  principle  obtained  from  Iceland 
moss,  and  used  as  a  stomachic.  It  increases  peristalsis, 
likewise  the  secretion  of  saliva,  bile,  and  pancreatic 
juice.  Average  dose,  gr.  iss.-i  Gm. 

Chaulmoogra  Oil  is  a  frothy  substance  obtained  from 
seed  of  Gynocardia  odorata;  used  in  the  treatment  of 
leprosy  and  tubercular  conditions.  Average  dose, 
Tii  xv.-i  mil. 

Chloralformamidum  is  a  preparation  made  by  the 
interaction  of  chloral  and  formamid,  in  the  form 
of  colorless  crystals,  employed  as  a  substitute  for 
chloral,  being  not  so  depressing  as  the  latter,  yet  less 


302  MATERIA  MEDIC  A   FOR  NURSES. 

certain  in  its  hypnotic  action.     Average  dose,  gr.  xv.- 
i  Gm. 

Chloralose  is  a  compound  of  chloral  with  grape  sugar 
in  the  form  of  fine  colorless  crystals,  with  a  bitter  taste, 
freely  soluble  in  hot  liquids,  but  slightly  so  in  cold 
water.  It  is  used  as  a  hypnotic,  but  is  not  so  reliable 
as  chloral.  Average  dose,  gr.  iii.-o.2  Gm. 

Chloretone  is  a  compound  formed  by  the  action  of 
caustic  potash  on  equal  parts  of  chloroform  and 
acetone.  It  is  used  as  an  antiemetic  in  preg- 
nancy, seasickness,  and  menstrual  sickness,  as  a 
hypnotic  and  external  antiseptic.  Average  dose,  gr. 
xv.-i  Gm. 

Chrysarobin  is  a  principle  obtained  from  goa  powder 
found  in  the  stems  and  branches  of  Andira  arabolea, 
in  the  form  of  a  light  yellow  crystalline  powder,  and 
is  employed  in  the  treatment  of  various  skin  diseases 
in  an  ointment  of  10%. 

Condurango  is  the  herb  of  Gonololus  condurango,  used 
as  an  alterative.  Average  dose  of  fluid  extract,  m  xv.- 
i  mil. 

Comutin  is  one  of  the  active  principles  of  ergot,  a 
reddish  to  yellowish  product  (Kobert's)  or  white 
crystals  (Keller's),  used  in  place  of  ergot.  Dose,  gr. 
1*2-0.005  Gm. 

Coronillin  is  a  glucoside  from  the  seeds  of  Coronilla 
scorproides  forming  a  pale  yellow,  bitter  powder,  used 
to  strengthen  heart  action  and  increase  diuresis.  Aver- 
age dose,  gr.  iii.-o.2  Gm. 

CredPs  Ointment  contains  15%  soluble  metallic  silver 
and  is  employed  in  septic  inflammation  and  erysipelas. 

Creolin  is  an  emulsion  of  cresol,  a  derivative  of  car- 
bolic acid.  It  mixes  in  all  proportions  with  chloroform, 
ether,  and  alcohol,  and  with  water  forms  a  milky  solu- 
tion. It  is  used  locally  in  a  variety  of  ways. 

Cresol.  Is  official  and  is  derived  from  coal  tar.  It 
has  the  medicinal  qualities  of  its  group,  and  is  slightly 
soluble  in  water,  more  freely  so  in  glycerine,  alcohol, 
or  ether. 

Average  dose,  ity  i.-o.o5  mil. 


UNCLASSIFIED  DRUGS.  303 

Dermatol  contains  about  55%  of  the  oxide  of  bismuth. 
It  is  a  yellow,  odorless  powder,  insoluble.  It  is  an 
excellent  antiseptic,  used  in  place  of  iodoform.  It  is 
also  used  internally.  It  is  officially  listed  as  bismuth 
subgallate. 

Average  dose,  gr.  viii.-o.5  Gm. 

Locally  it  is  used  as  a  powder,  in  gauze,  emulsion, 
or  ointment.  Strength,  10-20  #. 

Diabetin  is  a  trade  name  for  laevulose  or  fruit  sugar. 

Dionin  is  the  hydrochloride  of  a  preparation  of  mor- 
phine, appearing  in  a  fine  white  crystalline  powder, 
possessing  the  narcotic  properties  of  morphine  without 
attaining  its  intensity.  Toleration  is  not  established 
by  its  use,  hence  it  is  used  for  the  morphine  habit. 
Its  properties  are  similar  to  codeine.  Average  dose, 
gr.  ^-0.015  Gm. 

Eucaine,  now  in  the  U.  S.  P.  as  Betaeucaine  Hydro- 
chloride,  is  a  synthetic  alkaloid,  in  action  like  cocaine. 
It  is  irritant  and  must  be  used  with  care. 

Eudoxin  is  artificially  produced  in  the  search  for 
inodorous  iodine  compounds.  It  contains  iodine  and 
bismuth  and  shares  their  qualities. 

Average  dose,  gr.  iii.-o.2  Gm. 

Eugenol  (official)  is  an  aromatic  phenol  obtained 
from  oil  of  clove  and  other  sources.  It  must  not  be 
exposed  to  air. 

Average  dose,  JH,  iii.-o.2  mil. 

Euphthalmin  is  a  synthetic  alkaloid  of  complex 
derivation,  sometimes_used  as  a  mydriatic,  usually  in 
2%  solution. 

Europhen  is  a  powder  containing  about  27  %  of  iodine, 
and  used  as  a  substitute  for  iodoform.  It  is  soluble  in 
alcohol,  ether,  chloroform,  and  oil.  As  a  dusting 
powder  it  is  used  in  a  strength  of  from  5-10,  %  and 
hypodermically  solutions  in  olive  oil  are  used  in  from 
3-10  #  strength. 

Ferratin. — This  organic  preparation  of  iron  is  made 
commercially  by  heating  animal  or  vegetable  albumin 
until  the  slimy  consistency  is  lost,  when  an  acid  is 


304  MATERIA  MEDIC  A  FOR  NURSES. 

added  and  a  ferric  compound  of  the  albuminoids  is 
formed.  This  after  drying  is  readily  soluble  in  alka- 
line solutions.  It  is  absorbed  more  rapidly,  and  is  less 
irritant  than  the  inorganic  preparations.  Contains  7  % 
of  iron.  Average  dose,  gr.  viii.-o.5  Gm. 

Glutolis  formaldehyde  gelatin,  exhibited  as  a  powder 
and  used  as  an  antiseptic. 

Htzmogallol  is  obtained  by  oxidizing  the  haemo- 
globin of  the  blood  by  the  action  of  pyrogallol  (a 
derivative  of  gallic  acid).  It  is  a  reddish  brown 
powder,  easily  assimilated.  It  is  insoluble  in  water, 
and  is  given  in  tablets  or  in  wine. 

Average  dose,  gr.  iii.-o.2  Gm. 

Hemoglobin  is  the  red  coloring  matter  of  the  blood 
corpuscles.  It  forms  a  red  powder,  soluble  in  water. 

Average  dose,  gr.  ii. -0.125  Gm. 

Helmitol  is  a  compound  of  a  preparation  of  citric 
acid  and  urotropin  in  the  form  of  odorless  and  colorless 
crystals  with  a  slightly  acid  taste,  acting  as  diuretic 
and  antiseptic.  Average  dose,  gr.  viii.-o.5  Gm. 

HemoL  —  Obtained  from  haemoglobin  by  reduction 
with  zinc  dust.  Contains  0.2  %  of  iron.  A  number 
of  combinations  of  hemol  with  other  metals  are  in  use, 
possessing  the  tonic  properties  of  the  former  with 
the  medicinal  properties  of  the  latter.  Arsen-hemol 
contains  I  %  of  arsenous  acid.  lodo-hemol  contains 
1 6. 6  %  of  iodine.  Zinc  hemol  contains  i  %  of  zinc. 

Holocain  is  obtained  by  uniting  phenacetin  and 
para-phenetidin  in  the  form  of  insoluble  crystals  of 
bitter  taste,  and  used  as  a  local  anaesthetic  in  ophthal- 
mology in  solution  of  i  $. 

lodoformogen  is  an  odorless  compound  of  albumin 
and  iodoform:  It  is  dry,  impalpable,  does  not  form 
lumps,  and  is  three  times  lighter  than  iodoform,  in 
place  of  which  it  is  used. 

lodothyrin  is  obtained  from  the  thyroid  gland  of  the 
sheep  in  the  form  of  an  amorphous  brown  powder,  as 
a  milk-sugar  trituration;  used  as  an  alterative  in  an 
average  dose  of  gr.  xv.-i  Gm.  Contains  3%  iodine. 

Jequirity  is  the  seed  of  Abrus  precatorius,  the  active 


UNCLASSIFIED  DRUGS.  30$ 

principle  of  which  is  abrin  or  jequiritin,  which  is  used 
as  an  irritant  in  chronic  conjunctivitis.  It  is  extremely 
poisonous. 

Kola  contains  the  alkaloids  theobromine  and  caf- 
feine, and  a  principle  known  as  kolanin.  It  is  used 
internally  as  an  astringent.  It  lessens  tissue  waste, 
is  a  tonic  stimulant  to  the  circulation,  and  aids  the 
alcoholic  subject  in  resisting  the  craving  for  liquor. 

Lecithin  is  a  phosphate  obtained  from  the  yolks  of 
eggs,  and  is  used  in  nervous  affections.  Average  dose, 
gr.  iii.-o.2  Gm. 

Listerine  is  an  American  specialty  used  as  a  lotion 
or  mouth  wash,  and  contains  approximately  boric  acid 
25,  benzoic  acid  i,  thymol  i,  eucalyptol  I,  oil  of 
gaultheria  2,  oil  of  peppermint  J,  tincture  of  baptista 
15,  alcohol  (90  %)  325,  and  water  to  make  1000. 

Litmus  Paper  for  the  testing  of  urine,  etc.,  is  colored 
blue  by  impregnation  with  a  solution  of  litmus,  which 
is  a  dye  prepared  from  lichens  with  an  alkali.  Dipped 
into  an  acid  the  paper  turns  red,  and  the  color  is 
restored  by  an  alkali. 

Losophan  is  a  preparation  containing  about  78  4  of 
iodine.  It  is  used  in  powder,  ointment,  and  solution, 
in  from  10-20  %,  in  the  treatment  of  skin  diseases. 

Lysoform  is  a  combination  of  lysol  and  formaldehyde 
used  in  solution  of  5  to  10  $  as  a  disinfectant  and 
antiseptic. 

Lysotis  a  derivative  of  carbolic  acid,  containing  50  # 
of  cresols.  It  forms  a  soapy  liquid  with  water,  and 
combines  with  alcohol  and  glycerin.  It  is  used  as  a 
disinfectant  for  the  skin,  in  i  %  solution,  and  for 
wounds  and  abscesses  in  from  1-3  %. 

Magma  Bismuthi,  Milk  of  Bismuth  (official),  contains 
bismuth  subnitrate,  nitric  acid,  and  ammonium  carbo- 
nate. Average  dose,  3  i.~4  mils- 

Magma  Magnesia,  Milk  of  Magnesia  (official),  con- 
tains magnesium  carbonate  and  sodium  hydroxide. 

Average  dose,   3  iiss.-io  mils. 

Marrubin,  or  the  glycerine  extract  of  the  red  bone 
marrow,  may  be  used.  Average  dose,  3  i.-4  mils- 


306  MATERIA  MEDIC  A  FOR  NURSES. 

This  is  given   as  a  nutrient   substitute  for  cod-liver 
oil. 

Mel  Rosa,  Honey  of  Rose,  is  made  of  fluidextract  of 
rose  and  clarified  honey.  Average  dose,  3  i.~4  mils. 
Official. 

Methacetin  is  a  compound  analogous  to  phenacetin. 
It  is  tasteless  and  colorless,  soluble  in  alcohol,  gly- 
cerin, and  oil;  also  slightly  soluble  in  water.  It  has 
been  used  as  an  antiseptic,  analgesic,  and  antipyretic. 
It  is  rather  depressing,  and  has  sometimes  caused  col- 
lapse, lyarge  doses  may  bring  on  convulsions,  followed 
by  death. 

Average  dose,  gr.  ii.-o.i25  Gm. 

Methylal  is  a  local  anaesthetic  and  hypnotic,  derived 
from  alcohol.  It  is  soluble  in  water  and  alcohol,  and 
has  an  aromatic  odor  and  taste.  The  sleep  produced 
by  it  is  sound  but  of  short  duration.  It  is  depressing 
in  large  doses.  It  has  been  used  in  cases  of  insanity 
and  delirium  tremens. 

Average  dose,  ill  iii.-o.2  mil. 

Methylthionine  Chloride — Methylene  Blue  (official) — 
is  one  of  the  "  aniline  dyes."  It  is  slightly  soluble  in 
water.  It  is  a  bluish  powder,  and  has  been  used  as  an 
antipyretic  and  antiseptic.  It  is  also  considered  a  good 
antiperiodic.  It  is  given  in  wafers  or  capsules,  and 
hypodermically.  It  colors  the  urine  blue  or  greenish 
blue. 

Average  dose,  gr.  iiss.-o.i5  Gm. 

Migranin  is  an  antipyrin  preparation  containing 
antipyrin,  caffeine,  and  citric  acid. 

Average  dose,  gr.  viii.-o.5  Gm. 

Novaspirin. — Also  a  compound  of  sodium  salicylate. 
I,ess  nauseating. 

Average  dose,  gr.  V.-O.3  Gm. 

Novocaine. — Artificial  alkaloid  used  as  a  local  an- 
aesthetic. Action  similar  to  cocaine  but  is  less 
poisonous. 

Average  dose,  gr.  ss.-o.03  Gm. 

Nuclein  is  a  phosphorated  proteid  obtained  from  the 


UNCLASSIFIED  DRUGS.  307 

spleen  and  other  organs  in  the  form  of  a  pale  yellow 
powder,  soluble  in  alkaline  solutions  but  insoluble  in 
water  and  alcohol.  It  is  said  to  increase  the  number 
of  white  blood  cells  and  so  destroy  bacteria. 

Average  dose,  gr.  iii.-o.2  Gm. 

Orexin  is  a  derivative  of  chinolin.  It  is  a  gray 
powder  of  bitter  taste,  soluble  in  water  and  alcohol. 
It  is  used  as  an  appetizer  and  stomachic  tonic,  but  is 
somewhat  irritating,  and  should  not  be  given  on  an 
empty  stomach. 

Average  dose,  gr.  iii.-o.2  Gm.,  in  capsule,  at  meal- 
time, or  accompanied  by  food  or  some  nourishing  drink. 

Oxygen. — A  constituent  of  the  atmosphere  forming 
20%  of  its  volume.  Stored  under  pressure  in  metal 
tanks  for  use  (official). 

Action:  Antiseptic.  Improves  condition  of  blood 
and  stimulates  all  activity. 

Chief  use  in  pneumonia  when  patient  becomes  cyan- 
otic  due  to  imperfect  oxygenation  of  the  blood. 

Pellotine,  an  alkaloid  obtained  from  a  Mexican  plant 
and  used  in  the  form  of  the  hydrochloride  as  a 
hypnotic. 

Average  dose,  gr.  ss.-o.o3  Gm. 

Pental  is  a  hydrocarbon  obtained  from  fusel  oil  as 
a  colorless  liquid  and  used  as  a  general  and  local  anti- 
septic. It  is  depressing. 

Peronin  is  a  hydrochloride  of  the  benzyl  ether  of 
morphine,  the  action  of  which  is  between  that  of  mor- 
phine and  codeine.  Average  dose,  gr.  ss.-o.c»3  Gm. 

Picric  Acid,  Trinitrophenol,  an  explosive  combina- 
tion of  carbolic,  sulphuric,  and  nitric  acids,  is  of- 
ficial. It  is  a  yellow,  crystalline  powder,  soluble  in 
water.  Its  action  is  antiseptic,  astringent,  and  slightly 
irritant.  Applied  to  suppurating  burns  through  wet 
gauze  it  cleans  and  heals  them  readily.  It  should  be 
applied  thoroughly  in  all  cases,  the  acid  being  removed 
frequently  until  the  coagulated  lymph  covers  the  sore. 
It  may  also  be  applied  to  mucous  membrane,  in  the 
form  of  a  douche.  It  is  sometimes  rapidly  absorbed  and 
causes  poisoning,  the  characteristic  symptom  being  the 


308  MATERIA   MEDICA    FOR  NURSES. 

yellow  color  of  the  skin,  mucous  membranes,  and  urine. 
Convulsions  and  collapse  may  occur. 

Piperazineis  a  drug  formed  by  the  action  of  ammonia 
upon  ethylene  bromide.  It  is  used  as  a  diuretic,  its 
active  properties  arising  from  its  capacity  for  dissolving 
uric  acid. 

It  is  not  irritant  nor  poisonous. 

Average  dose,  gr.  x.-o.3  in  carbonated  water. 

Protargol. — A  silver  compound  containing  8.3%  of 
metallic  silver  combined  with  protein.  It  is  antiseptic, 
slightly  astringent,  non-irritant,  and  free  from  all  caus- 
tic or  corrosive  effects,  even  on  sensitive  membranes. 
It  is  used  in  I  to  2%  solutions.  It  should  be  kept  in 
amber  vials. 

Pyramidon  is  an  amido  derivative  of  antipyrin.  It  is 
milder,  more  gradual,  and  more  lasting  than  antipyrin. 

Average  dose,  gr.  v.-o.3  Gm. 

Pyrogallol. — Pyrogallic  acid  is  obtained  by  the  action 
of  heat  on  gallic  acid.  It  is  used  in  skin  diseases  as  a 
local  irritant,  caustic,  and  parasiticide.  It  stains  the 
skin  and  clothing  brown.  It  is  generally  employed  in 
the  form  of  ointment  or  in  flexible  collodion.  It  may 
cause  poisoning,  manifested  by  headache,  diarrhrea, 
chills,  vomiting,  a  reddish  color  to  the  skin,  dark 
brown  urine,  rapid  heart  and  respiration,  restlessness, 
convulsions,  coma,  and  death.  Official. 

Salipyrin. — This  drug  is  the  salicylate  of  antipyrin. 
It  is  considered  an  efficient  antipyretic. 

Average  dose,  gr.  viii.-o.5  Gm. 

Salophen  is  a  derivative  of  salol,  introduced  as  a  sub- 
stitute for  the  latter  in  order  to  avoid  effects  arising 
from  the  liberation  of  phenol  in  the  organism,  which 
occurs  when  salol  is  used.  Its  physiological  actions  are 
similar  to  those  of  salol. 

Dose,  gr.  viii.-o.5  Gm. 

Salvarsan,  Called  "606"  or  Arsenobenzol. — A  com- 
plex organic  arsenic  salt  put  up  for  use.  It  is  a  yellow 
powder  sealed  in  glass  tubes. 

Action:  As  a  specific  in  syphilis,  by  destroying  the  or- 
ganism, Spirocheta  pallida,  and  neutralizing  its  poisons. 


UNCLASSIFIED  DRUGS.  309 

Administration:  A  suitable  dilution  of  the  drug  in 
distilled  water  is  administered  by  venous  transfusion. 
Occasionally  this  solution  is  administered  by  deep  in- 
jection into  the  muscles. 

Average  dose,  gr.  viii.-o.5  Gm. 

The  administration  of  the  drug  produces  reaction  of 
more  or  less  severity  in  some  cases.  There  may  be  a 
chill  with  accompanying  high  temperature.  Blindness 
has  resulted  and  the  usual  signs  of  arsenical  poisoning 
may  make  their  appearance. 

Sanatogen  is  a  combination  of  sodium-glycero-phos- 
phate  and  casein,  used  as  a  nutrient  tonic. 

Somatose  is  a  preparation  of  meat  in  such  a  way  as 
to  be  readily  digestible,  five  parts  of  the  preparation 
representing  thirty  parts  of  meat.  Iron  somatose  and 
milk  somatose  are  preparations  with  iron  and  from  milk, 
respectively. 

Somnalis  made  by  the  combination  of  chloral,  alcohol, 
and  urethan.  It  is  a  colorless  liquid  which  will  not 
mix  with  cold  water,  but  dissolves  in  alcohol,  or  hot 
water.  It  is  quite  an  efficient  hypnotic,  and  usually 
prompt  in  its  action.  Its  effects  are  considered  less 
depressing  than  those  of  chloral,  and  more  active  than 
those  of  urethan. 

Average  dose,  "rtl  xv.-i  Gm.,  usually  given  in  syrup 
of  tolu. 

"Styptidn"  no  longer  so-called,  is  officially  Cotamine 
Hydrochloride.  It  is  obtained  from  narcotin,  one  of  the 
alkaloids  of  opium.  It  is  given  in  solution,  or  in 
powder,  wrapped  in  wafers,  or  best,  in  gelatine  pearls. 
It  may  also  be  used  hypodermically. 

Average  dose,  gr.  i.-o.o6  Gm. 

Taka-diastase  is  a  starch-digesting  ferment  obtained 
from  fungus  grown  on  wheat  bran.  Average  dose,  gr. 
v.-o.3  Gm. 

Tannalbin  is  a  red  brown  product  made  by  combining 
tannin  and  albumin,  and  used  as  an  intestinal  astringent. 
Average  dose,  gr.  x.-o.65  Gm. 

Terebenum  (Terebene)  is  a  colorless  liquid,  of  hot 
taste,  obtained  by  chemical  process  from  oil  of  tur- 


310  MATERIA    MEDIC  A    FOR  NURSES. 

pentine.    It  is  used  as  a  stimulant  expectorant.    Official. 
Average  dose,  TTJ,  iv.-o.25  mil,  in  an  emulsion  or  in 
capsule. 

Terpini Hydras,  Terpin  Hydrate  (official),  is  made  from 
turpentine  but  has  no  odor  of  turpentine.  It  is  used  as 
an  expectorant. 

Average  dose,  gr.  iv.-o.25  Gm.,  given  in  tablets  or 
syrup. 

Terpinol  is  an  oily  liquid,  obtained  by  combining 
terpine  and  hydrochloric  acid.     It  has  the  same  stimu- 
lant and  expectorant  properties  as  terpin  hydrate,  and 
is  used  under  similar  circumstances. 
Average  dose,  TH,  viii.-o.5  mil. 

Tetronal  is  a  compound  allied  to  sulphonal,  and  in 
general  similar  to  trional. 

Average  dose,  gr.  yiii-o.5  Gm. 

Theophylline  (official)  formerly  known  by  the  name 
theocin.     It  is  obtained  from  the  teaplant  and  is  also 
produced  chemically.     It  has  diuretic  qualities. 
Average  dose,  gr.  iv.-o.25  Gm. 

Thymacetin  is  a  derivative  of  thymol,  and  related  to 
phenacetin.     It  is  used  as  an  analgesic  and  hypnotic. 
The  after-effects  are  sometimes  unpleasant. 
Average  dose,  gr.  v.^-o.3  Gm. 

Thymol  Iodide  contains  about  43%  of  iodine,  and  is 
used  as  a  substitute  for  iodoform.  It  is  not  poisonous. 
It  is  official. 

Trional,  now  officially  Sulphonethylmethane,  is  chemi- 
cally allied  to  sulphonal,  and  is  given  as  a  hypnotic, 
and  also  as  an  antihydrotic.  When  it  is  successfully 
given  it  produces  a  quiet  sleep  and  a  natural  awaken- 
ing, but  if,  after  being  given  twice  in  succession,  no 
results  follow,  it  is  useless  to  try  it  further.  When  it 
acts,  it  acts  quickly,  and  sleep  comes  on  within  a  short 
time.  It  is  not  given  for  more  than  five  or  six  nights 
in  succession,  as  it  sometimes  causes  prostration.  It 
is  apt  to  accumulate  in  the  blood,  and  to  avoid  this, 
mineral  waters  are  taken  in  conjunction  with  it.  It 
causes  constipation,  and  this  must  be  watched  for  and 
overcome.  It  is  given  in  hot  milk  just  before  retiring. 


UNCLASSIFIED  DRUGS.  $11 

Average  dose,  gr.  xii.-o.y5  Gm. 

Tropococain  is  an  alkaloid  from  a  variety  of  coca,  used 
lik  cocaine  as  a  local  anaesthetic.  It  is  very  costly. 

Tussol  is  anti-pyrinin-mandelate,  and  is  used  as  an 
antispasmodic.  Average  dose,  gr.  i.-o.o6  Gm. 

Urotropin  is  now  officially  Hexamethylenamine  and 
has  lost  its  trade  name.  Formed  by  the  action  of  for- 
maldehyde and  ammonia.  It  is  a  urinary  antiseptic, 
sterilizing  the  urine  by  giving  off  some  of  its  formalde- 
hyde. It  increases  the  flow  of  urine  and  the  excretion 
of  uric  acid,  the  solution  of  the  urates  beginning  within 
twenty-four  hours  after  the  ingestion  of  the  drug. 

Average  dose,  gr.  iv.-o.25  Gm. 

Veronal  is  a  hypnotic  which  in  excess  may  cause  a 
rash,  neuralgic  pains,  or  loss  of  muscular  control. 
Over-use  induces  constipation  and  diminishes  excretion 
from  the  kidneys.  I^arge  doses  have  caused  death. 

Average  dose,  gr.  iv.-o.25  Gm. 


INDEX 


NOTE. — The  preparations  of  drugs  which  are  found  in  the 
Ninth  Decennial  Revision  of  the  United  States  Pharmacopoeia 
are  set  in  the  index  in  italics.  Unofficial  drugs  are  set  in  Ro- 
man letters,  as  are  also  the  general  names  of  metals  and  plants 
which  do  not  appear  as  such  in  the  Pharmacopoeia. 


Absorbent  Cotton  . 

PAGE 
189 

Nitric       .         .     ' 

PAGE 
110 

Absorbents  . 

4 

Nitrohydrochloric 

112 

Absorption  . 

4 

Diluted. 

112 

Aceta 

9 

Oleic 

163 

Acetal 

298 

Oxalic       .         , 

122 

Acetanilid    . 

J59 

Phosphoric         + 

"3 

Acetanilidum 

159 

Diluted 

113 

Incidental  Effects 

160 

Salicylic             . 

152 

Related  Drugs  . 

160 

Sulphuric  . 

109 

Acetic  Acid  . 

114 

Aromatic        , 

110 

Diluted     .         .     , 

"5 

Diluted 

no 

Acetone         ,          , 

298 

Sulphurous       . 

H3 

Acetozone    .         . 

298 

Tannic     ,         « 

117 

Acetphenetidin 

161 

Tartaric             . 

117 

Acetum        . 

H5 

Acidum; 

Acids: 

Aceticum  .         » 

114 

Acetic       .        ., 

114 

Dilutum         ., 

H5 

Diluted           « 

US 

Benzoicum         . 

217 

Arsenous  . 

87 

Boricum   . 

H3 

Benzoic     . 

217 

Carbolicum  (Phenol) 

148 

Boric 

H3 

Citricum  .         » 

116 

Carbolic  (Phenol) 

148 

Gallicum 

118 

Citric 

116 

Hydrochloricum  . 

in 

Gallic 

118 

Dilutum         ,. 

112 

Hydrochloric 

III 

Hydrocyanicum 

119 

Diluted           ,      , 

112 

Dilutum 

119 

Hydrocyanic     . 

119 

Lacticum  . 

119 

Diluted 

119 

Dilutum 

119 

Lactic 

119 

Nitricum  . 

no 

3' 

3 

INDEX. 


PAGE 

A  cidum — Continued 

Nitrohydrochloricum   .       112 

Dilutum          .  .       112 

Oleicum    .         .  .163 

Oxalicum           .  *  .       122 

Phosphoricum    .  .      113 

Dilutum          .  .113 

Salicylicum        .  .       152 

Sulphuricum      .  .109 

Aromaticum  .  .       no 

Dilutum       '•;';'  .      no 

Sulphurosum     .-,-.  .      113 

Tannicum          .  ;'.       117 

Tartaricum        .    ,  .       117 

Aconite         .          .  .      165 

Extract  of          .  .       168 

Fluidextract  of  .  .       167 

Liniment  of       .  .168 
Physiological  Actions 

27,  33,  165 

Precautions       .         .  167 
Symptoms  of  Poison- 
ing       .          .          .  166 
Tincture  of         .          .  168 
Treatment  of  Poison- 
ing        .          .  '       .  167 
Aconitina     .          ._,    ,  .  168 
Aconitine     .          .          .168 
Action  of  Drugs,  Physio- 
logical            .          .    4,  26 
Active      Principles      of 

Drugs   .          .         .,    '  2 

Adeps           .         .       ',  263 

Benzoinatus       .          .  264 

Lana        .         ."...,  264 

Adhesive  Plaster    .         .  65 

Adonidin      .          • '*  j     •  170 

Adonis  Vernalis    .          .  170 

Infusion  of         .          ,  170 

Physiological  Actions  170 

Preparations      ,          ,  170 

Adrenalin     .          .          .  286 

Adrenalin  Chloride  Sol.  287 

JEther  ^          .          .,...,  .  136 

^Ethylis  Bromidum        .  139 

J&tliylis  Chloridum         ,  140 

Agaricin       ;         1    .      .  260 


PAGE 

Agaricus       .          .          .260 
Airol   .          .          .          .298 
Albolene       .          .          .      298 
Albuminous  Bodies        .          2 
Alcohol          .          .        123-130 
Absolute    .          .          .131 
Amyl,  Amylicum        .       124 
Dehydrated         .          .       131 
Diluted,  Dilutum         .       131 
Ethyl,  Ethylicum        .       124 
Methyl,  Methylicum.       124 
Physiological  Actions       125 
Preparations      .          .130 
Symptoms  of  Poison- 
ing       .          .         .      130 
Alcoholic  Beverages       .      131 
Ale      .          .          .          .      133 
Alkali.  .          .        40 

Alkalies        .  .      .  40, 41 

Alkaline   Gentian   Mix- 
ture      .          .          .      224 
Alkaloids      .          .          .    2,  40 
of  Aconite          .          .168 
of  Opium.          .          .180 
Aloes  .          .          .      252 

Aloin  ....  252 
Alteratives  .  .  .  4,  38 
Alum  ...  72 

Dried  .  .  .  73 
Physiological  Actions  72 
Preparations  .  .  72 
Symptoms  of  Poison- 

ing         ...        72 

Alumen         ...        72 

Exsiccatum         .          .         73 

Alumini  Hydroxidum     .        72 

Aluminum  Hydroxide     .        72 

Alumnol       .          .          .156 

American  Hellebore       .      254 

Ammonia     .          .          .  40,  54 

Aromatic  Spirit  of       .        56 

Carbonate  of  -55 

Chloride  of  -55 

Liniment  .          .          .        57 

Physiological  Actions         54 

Preparations     "'.,••      .        55 

Salts  of     .          .          .  41,  42 


INDEX. 


315 


PAGE 

PAGE 

Ammonia  —  Continued 

Antimonii    et     Potassii 

Symptoms  of  Poisoning     54 

Tartras.         .         .        91 

Treatment  of  Poison- 

Antimonium         .          .        91 

ing        .         .         .        55 

Antimony     .          .          .         91 

Water       ...        56 

and    Potassium    Tar- 

Stronger          ,    ,               56 

trate      ...        91 

Ammoniated  Tincture  of 
Valerian         .          .      214 

Symptoms  of  Poisoning      93 
Treatment  of  Poison- 

Ammonii, Bromidum     .      100 

ing        .          .         .93 

Carbonas  .        •  .    .      .        55 

Wine  of    .       '  .   •      .        93 

Chloridum       ...  .       ..        55 

Antinervin  .     '•-.  v'1       »•      160 

Ammonium           .      41,  42,  54 

Antiperiodics         .          .   4,  38 

Bromide           ,  ..  •       .       100 

Antiphlogistics      .          .        37 

Carbonate        42,  43,  55,  276 

Antiplague  Serum          .      285 

Chloride             .         .  42,  55 

Antipyretics          „•     5,  38,  157 

Salts                   .     41-43,  55 

Antipyrina            .         .       157 

Amygdala  Amara           .       198 

Antipyrine  .         .        -.      157 

Amylene  Hydrate          *      145 

Physiological  Actions       158 

Amyl  Hydrate      ..'•,     ...  •     124 

Antiseptics  .         »         •    5»  39 

Amylis  Nitris        .          »      145 

Antiseptin    .        i.         .      106 

Amyl  Nitrite          .          .,145 

Antiseptol    .          .         .      106 

Anaesthetics           .          .    4,  33 

Antisialagogues     .          *        29 

General    ....       >         .        33 

Antispasmodics     .        •  .    5,  34 

Local        ...        33 

Antitetanic  Serum  .         .284 

Analeptics    ,         .         .          4 

Antitoxins    .          279,  282-284 

Analgen       .          .         .      298 

Antityphoid  Serum        .      285 

Analgesics    .         .          .    4,  33 

Antivenene        .    „'        .      286 

Anesthol       .          .         .,     298 

Antizymotics         ..  ,..      .           5 

Anhidrotics            .»  ,.     ,>      36 

Aperients     .          .          .    5,  30 

Animal  Kingdom.            I,  262 

Apiol  ....      299 

Anodynes     .         .          .4,  33 

Apocodeine          Hydro- 

Antacids      .          .         .,.         4 

chloride          .         .299 

Anthelmintics       .          .    4,  31 

Apomorphina   Hydro- 

Antiarthritics        .          .          4 

Moridum       .         .       182 

Antidiphtheric  Serum     .      268 

A  pomorphine       Hydro- 

Antidotes     .      .    .        271-274 

chloride         .         182,  276 

Acids        .         .          .271 

Apothecaries'  Weight     .        23 

Arsenic    .         .         .  78,  89 

Approximate       Equiva- 

Antiemetics.        .         ..       30 

lents      ...        24 

Antifebrin    .          .         .«*     159 

Aqua: 

Incidental  Effects      .      1  60 

AmmonicB          .         .        56 

Related  Drugs  .         *,     160 

Fortior         --.,        .        56 

Antigalactagogues          .,       35 

Camphor  as         .,        .      239 

Antigonococcus  Serum  .      269 

Chloroformi       .        ..      135 

Antihydropics       .         •.*..  ,      4 
Antikamnia.          .         .      160 

Creosoti    .'.        .'.        .      152 
Fortis       .          .          .no 

Antilithics    ...          4 

Mentha  Piperite        .      237 

316 


INDEX. 


PAGE 

PAGE 

Aquae  ....          9 

et  Potassii  Bromidum        68 

Argenti  Nitras      .         .        65 

et  Sodii  Chloridum      .        67 

Ar  genii  Nitras  Fusus     .        67 

Aurum         ...        67 

Argenti  Nitras  Mitigatus      67 

Argentum    ...        65 

Argol  ....        43 

Bacillus  Bulgaricus        .      269 

Argyrol        .          .          .      299 

Bacterial  Vaccine.          .      269 

Aristol          .         .        106,  299 

Balsam  of  Peru     .  .       .       195 

Arnica          .         .         .      215 

Balsam  of  Tolu     .          .196 

Aromatic  Powder  .         .      240 

Balsamum  Peruvianum         195 

Aromatic  Spirit  of  Am- 

Balsamum Tolutanum    .       196 

monia   ...        56 

Base    .                   .          .40 

Aromatic  Sulphuric  A  cid      no 

Basham's  Mixture          .        76 

Aromatics    .       .  '•.  |      .  .      2,  5 

Bebeerin       .          .          .      300 

Arrow  Poison         .         .      225 

Beer             .         .          .133 

Arseni: 

Belladonna,  Leaves         .      226 

lodidum   ...        90 

Extract     .         .         .      229 

Trioxidum      '  •*  .•      .  87,90 

Fluidextract,  Root       .      229 

Arsenic         .         .         .87 

Physiological  Actions       226 

Fowler's  Solution  of           90 

Plaster      .          .          .      229 

Iodide  of                              90 

Poisoning           .          .      227 

Physiological  Actions         87 
Preparations     .                 90 

Tincture,  Leaves          .      229 
Treatment  of  Poison- 

Treatment of  Poison- 

ing        .         .         .      228 

ing        ...        89 

Benzanilid   .         .         .160 

Trioxide  .         .         .87,  90 

Benzoate: 

While       ...        87 

Ammonium        .         .      218 

Arsenium     .          .         ,.87 

Sodium     .         .          .218 

Arsenobenzol         .          .299 

Benzoic  Acid                   .217 

Arsenous  Acid       .         .  87,  90 

Benzoin        .         .         .217 

Solution  of         .         .90 

Benzoinated  Lard  .         .264 

Asafetida      .          .          .      205 

Benzoinum  .          .          .217 

Emulsion  of       .          *      206 
Pitts  of     .          .          .      205 

Benzonaphthol      .        156,  300 
Benzosol      .          .        152,  300 

Tincture  of        .          .      206 

Benzosulphinidum           .       162 

Asaprol        .         .        156,  299 

Betanaphthol          .         .156 

Aseptol         .         .          .299 

Betol  .          .          .156,  300 

Asparagin    .         .         .299 

Biniodide  of  Mercury     .        84 

Aspidium     .         .          .260 

Bismuth       ...        94 

Aspirin         .         .          .299 

Physiological  Actions         94 

Astringents  .         .          .    5,  36 

Subnitrate  of                .94 

Atoxyl          .         .         .      300 

Bismuthi  Subnitras        .        94 

Atropina      .         .         .      229 

Bismuthum           .          .        94 

Atropina  Sulphas           .      229 

Bismuton     «         .          .      300 

A  tr  opine       .          .          .      229 

Bismutose    .          .          .      300 

Sulphate  .         .         .      229 

Bitter  Almond      .          .198 

Auri  Cbloridura    .         .        68 

Bitter  Principles  .         .          2 

INDEX. 


317 


Bitters         .     .'  ,    '  •  *: 

PAGE 

2,  5 

Caffeina       .         .         v 

PAGB 
212 

Aromatic 

2,  5 

Caffeine        .         .  . 

212 

Simple      .         .         . 

2,  5 

Calabar  Bean 

I96 

Blackberry  .          .         . 

199 

Physiological  Actions 

I96 

Black  Haw  . 

106 

Poisoning 

I96 

Black  Snakeroot    . 

169 

Preparations 

197 

Black  Wash 

86 

Calcii  Chloridum  . 

60 

Blaud's  Pills 

77 

Calcii  Hypophosphis 

97 

Blisters 

8,36 

Calcium 

4i,57 

Blue: 

Chloride    .         . 

60 

Gum  Leaves       ,         , 

199 

Hypophosphite 

97 

Mass        .     '•"". 

85 

Oxide 

57,58 

Ointment  . 

85 

Chlorinated    . 

98 

Vitriol      . 

Preparations     ..        •«• 

58 

Borax 

53 

Calefacients          >  -.      . 

5 

Boric  Acid   . 

Calomel        .         .         « 

84 

Physiological  Actions 

114 

Calumba      .                  , 

171 

Ointment  of 

114 

Fluidextract  of 

172 

Borosalicylate  of  Glycerin 

300 

Tincture  of        . 

172 

Brandy        .         .         « 

131 

Calx    .... 

57,58 

Brimstone 

1  06 

Chlorinata         ,        ', 

98 

Bromal  Hydrate   . 

300 

Camellia  Thea      .         . 

213 

Bromide  of  Ether  .       .  ; 

139 

Camphor      .         • 

238 

Bromide: 

Liniment  .         « 

239 

Ammonium 

IOO 

Oil            . 

240 

Lithium    .          .         . 

IOO 

Spirit  of  .         i 

239 

Potassium 

99 

Water       .         .        .< 

239 

Sodium    .         .-/;'    '>.'»•• 

IOO 

Camphora    . 

238 

Bromidia      .         .         ; 

301 

Camphorated  Tincture  of 

Bromine 

99 

Opium  . 

179 

Incidental  Effects  of  . 

IOO 

Cannabis      .         .         * 

245 

Physiological  Actions 
Preparations 
Bromipin     „ 

99 
99 
301 

Cantharidal  Collodion 
Cantharides           .  '       • 

Cantharis     .         .       '  . 

189 
265 
265 

Bromocoll    .         ,         .  • 

301 

Capsicum     . 

232 

Bromoform  .         .         ; 

301 

Plaster      .   _      .         . 

232 

Bromum      .         .         . 

99 

Carbo  Animalis    .         >. 

1  08 

Broom  Tops         . 

194 

Carbo  Ligni 

1  08 

Brucine        .         .         ; 

220 

Carbolic  Acid  (Phenol)    . 

148 

Buchu           .         .         i 

190 

Physiological  Effects 

149 

Burgundy  Wine    . 

133 

Symptoms  of  Poison- 

Butyl Chloral  Hydrate 

143 

ing        .          . 

150 

Treatment  of  Poison- 

Cacao Butter         .- 

190 

ing        . 

150 

Cachets 

12 

Carbon  Compounds 

123 

Cacodyl    (Arsenic)    De- 

Carbonates . 

rivatives 

301 

Cardamom   . 

245 

318 


INDEX. 


PAGE 

PAGE 

Cardamomum        .     •'••;«* 

245 

Camphor 

143 

Cardiac: 

Croton      .          .     .•»'«.-.- 

Depressants      ,       ',1 

5 

Hydrated  . 

140 

Diuretics 

34 

Incidental  Effects 

142 

Sedatives           . 

27 

Physiological  Actions 

I4O 

Stimulants         *.        .:. 

5,  26 

Symptoms  of  Poison- 

Tonics     . 

26 

ing 

141 

Carminatives        .      .    . 

5,  30 

Treatment  of  Poison- 

Canon Oil    . 

59 

ing        ... 

141 

Caryophyllus 

201 

Chloralformamidum 

301 

Cascara  Sagrada   .      $  »•• 

193 

Chloralose    . 

302 

Castor  Oil     . 

242 

Chloralum  Hydratum 

140 

Cathartics    .     .  •  <.        -. 

5,  30 

Chlorate,  Potassium 

46 

Aperient  .        ..     ,:...; 

5»  30 

Chloretone 

302 

Cholagogue       .    ;>•-. 

Chlorides     . 

41 

Drastic     .         .  . 

5>  3^ 

Chlorinated  Lime  . 

98 

Hydragogue      ...-      s. 

5^3i 

Chlorine       .         . 

97 

Laxative  .          .    .     . 

5,30 

Chlorodyne 

135 

Saline       .       •  .'•  •       . 

5»  31 

Chloroform  . 

133 

Simple 

31 

Anaesthesia 

J35 

Cathartic  Vegetable  Pills 

202 

Liniment  . 

135 

Caustic  Potash 

45 

Compound    . 

135 

Caustics       .         .       ;% 
Cayenne  Pepper    .     .  .;. 

6,36 
232 

Physiological     Ac- 
tions    . 

133 

Cerata          .          .          . 

9 

Spirit  of  . 

135 

Cerate,  Goulard's 

65 

Symptoms  of  Poison- 

of Lead  Subacetate    . 

65 

ing                 .     i   * 

134 

Cerates. 

9,  ii 

Treatment  of  Poison- 

Ceratum   Plumbi    Sub- 

ing        ... 

134 

acetatis    .          ... 

65 

Water 

135 

Cerebral:      .         . 

Chloroformum 

133 

Depressants      .         ; 

33 

Chlorum 

97 

Stimulants        r         . 

33 

Cholagogues 

6,31 

CeriiOxalas. 

61 

Chrysarobin 

302 

Cerium 
Oxalate     .         ,        .;*.• 

61 
61 

Cimicifuga   . 
Fluidextract  of   . 

169 
170 

Cetaceum      .       .  ..  .   .   . 

264 

Preparations 

170 

Cetrarin       .         .  *•     . 

301 

Tincture  of 

170 

Chalk  Mixture       . 

59 

Cinchona 

206 

Chalk,  Prepared    . 

59 

Cinnamomum 

240 

Champagne.         .   ••     . 

133 

Cinnamon    . 

240 

Charcoal 

108 

Circulatory  System 

26 

Charta         .          . 

9 

Citrate 

41 

Chaulmoogra  Oil 

301 

of  Magnesia,  Solution 

6l 

Chinolin       .      •-  ,         . 

156 

Citric  Acid  . 

116 

Tartras    .         ,,        . 

157 

Citrine  Ointment    . 

86 

Chloral         .         .     ,:» 

140 

Claret          .     •  ^.         . 

133 

INDEX. 


319 


Classification,  of  Reme- 
dies      .          .  26 
of  Antitoxins,  Vaccines, 

and  Sera        .        282-283 

Cloves  .         .         .201 

Coca  .         .          .185 

Poisoning          ,         .      186 

Preparations     .         .      187 

Cocaine  Chloride    .          .       187 

Cocaines  Hydrochloridum      187 

Cocaine  Hydrochloride,  187,279 

Codeina        .     y    ..        .182 

Codeine        .         .        -.182 

Phosphate          .         .182 

Sulphate   .         .     •   .      182 

Cod  Liver  Oil         .         .      264 

Coffea  Arabica      .         .      212 

Coffee  Plant          .          .      212 

Colchici  Cormus    .         .256 

Colchicina    .         .         .258 

Colchici  Semen      .         .256 

Colchicum    .         .         .256 

Physiological  Actions       256 

Poisoning        '  .         .      257 

Preparations      .          .258 

Root          .         .         .      256 

Seed          .         .         .      256 

Collapsubes.         .         .        12 

Collodion      .         .         .189 

Flexible     .         .         .189 

Vesicating          .          .189 

Collodium     .         .         .189 

Cantharidatum  .         .189 

Flexile      .         .         .189 

Colocynth     .         .  201 

Colocynthis  .         .201 

Combined  Diuretics       .        34 

Common  Measure  and 

Metric  ..,.  •  ._  23 
Common  Salt  .  .  51 
Compound: 

Cathartic  Pills  .  .  202 
Chloroform  Liniment  135 
Effervescing  Powder  .  53 
Extract  of  Colocynth  .  202 
Fluidextract  of  Sar- 
saparilla  .  .251 


Infusion  of  Senna 
Iron  Mixture 
Licorice  Powder 
Morphine  Powder 
Powder  of  Jalap 
Spirit  of  Ether  . 


198 
77 
195 
181 
225 
138 


Syrup  of  Sarsaparilla  251 
Syrup  of  Squill           93,  251 
Tincture  of  Benzoin    .  218 
Tincture  of  Cinchona  .  207 
Tincture  of  Gentian     .  224 
Tincture  of  Lavender  .  237 
Tincture  of  Opium     .  180 
Condurango          .          «•  302 
Confectio  Sennae  .         ..198 
Confections           .        .*  n 
Conine         .         .  \      203,  205 
Conium        .          .          .  203 
Physiological  Actions  204 
Preparations      .      :,  .  205 
Symptoms  of  Poison- 
ing       .         . .      . .  204 
Convallaria           .         .  252 
Convallarin           .         «  252 
Convallamarinum.     ...  253 
Convulsants        ..      :, .  6 
Copaiba        .         ,     .  <v  194 
Copper  ^       .         .         .70 
Arsenite  .         .     •  ;•  91 
Preparations  of .     .    .  71 
Sulphate  .          .          71,  276 
Symptoms  of  Poison- 
ing       .          .          .  71 
Treatment  of  Poison- 
ing       .         .      ;  ,.-  71 
Cornutin               .         •.  302 
Coronillin              .  '      •..  302 
Correctives            .          .  6 
Corrosive  Mercuric  Chlo- 
ride      .          .         .:  82 
Corrosive  Sublimate        .  82 
Cotarnine  Hydrochloride  309 
Goto  Bark   .          .          .241 
Cotoin          .          .     •    .  •  241 
Cotton,  Soluble,  Gun       .  189 
Counter-irritants  .          .    7,  36 
Cream  of  Tartar    .         .  49 


320 


INDEX. 


Grade's  Ointment. 
Creolin 
Creosote 
Water 
Cresol 
Creosotum 
Creta  Prcsparata    . 
Croton  Chloral     . 
Croton  Oil    . 
Cumulative  Action 
Cupri  Arsenis     ^ . 
Cupri  Sulphas 
Cupric  Sulphate    . 
Cuprum 

Dandelion    . 

Daturine 

Deadly  Nightshade 

Decocta 

Decoctions  .        v  . 

Delphine 

Demulcents . 

Deodorants 

Deodorized    Tincture    of 

Opium  . 

Depilatories          . 
Depresso-Motors  . 
Depurants   . 
Dermatol 

Desiccated  Pituitary  Body    268 
Desiccated      Suprarenal 

Glands  . 
Desiccated  Thyroid 

Glands  . 
Detergents  . 
Diabetin 
Diacetylmorphine  . 

Hydrochloride    . 
Diachylon  Ointment 

Plaster      . 
Dialyzed  Iron 
Diaphoretics        -, 
Diastase 

Digestive  System 
Digitalin      .         . 
Digitalis 

Fluidextract  of    .  •  •  '•  V 


PAGE 

PAGE 

302 

Incidental  Effects 

235 

302 

Infusion  of 

236 

151 
152 
302 

Physiological  Actions 
Poisoning 
Preparations     . 

233 
234 
236 

151 

Diluents 

6 

59 

Diluted,  Acetic  Acid 

115 

143 

Alcohol     . 

131 

241 

Hydrochloric  Acid 

112 

3 

Hydrocyanic  Acid 

119 

9i 

Lactic  Acid 

119 

7i 

Nitro-Hydrochloric 

7i 

Acid     . 

112 

70 

Phosphoric  Acid 

IJ-7 

Sulphuric  Acid 

110 

215 

Dionin 

303 

230 

Diphtheria  Antitoxin, 

226 

268,  279,  283 

9 

Diphtheric  Antitoxin  Glo- 

9 

bulins   . 

269 

168 
6,37 

Behring's  . 
Gibier's    . 

283 
283 

6,  39 

Roux's      .       _.  

284 

Schering-Aronson 

284 

179 

Disinfectants 

6,  39 

6 

Dispensatory 

8 

6 

Diuretics      .          .         t 

It  6»  34 

6 

Dobell's  Solution 

303 

Donovan's  Solution 

91 

268 

Dosage 
Dover's  Powder 

19 

1  80 

268 

Drastics 

5.  3i 

Dried,  Alum          . 

73 

267 

Diphtheria  Antitoxin 

269 

6 

Thyroids  . 

267 

303 

Drug 

i 

181 

Drugs,  Action  of  . 

2,  3 

181 

Active  Principles 

2 

65 

Administration  of 

18,  19 

65 

Age  in  Relation  to 

3,  18 

79 

Albuminous  Bodies 

2 

6,36 

Alkaloids 

2 

261 

Cumulative  Action 

3 

29 

Effects,  Primary 

4 

237 

Secondary 

4 

233 

Food  in  Relation  to 

3,  4 

236 

Forms 

i 

\INDEX.                                        321 

PAGE 

PAGE 

Drugs  —  Continued 

Emplastrum  : 

Glucosides         .         ,v  "       2 

Adhcesivum 

65 

Gums       ..'"       .'      '  ,          2 

Belladonna 

229 

Habit       .         .         ,          3 

Capsici 

232 

Hypodermics     .         »        19 
Idiosyncrasy     .         ,          3 

Plumbi     . 
Saponis    . 

65 
65 

Liquid  Preparations  .          9 

Emulsa        .: 

9 

Oils           .         .         „          2 

Emulsions    . 

9 

Oleoresins          .          .2 

Epispastics  .     . 

7,36 

Physiological  Actions           I 

Epsom  Salt  . 

60 

Principles          .         .          2 

Ergot 

258 

Aromatic       .         ,          2 

Ergotin 

259 

Bitter   .                   ^          2 

Errhines 

7 

Odorous   '                          2 

Escharotics 

7,36 

Recent    Methods    of 

Eserine 

196 

Exhibiting     .          .        12 

Ether 

136 

Resins       .          .                     2 

Bromide  of 

139 

Sleep  in  Relation  to  .          4 
Solid  Preparations     .    9,  1  1 
Source      .          .         j     I,  2 

Compound  Spir 
Physiological  A 
Preparations 

tof 
ctions 

138 
S 

Starches  ...          2 

Spirit  of  . 

138 

Sugars      ^         .                    2 

Nitrous 

138 

Toleration       •".         .  •        3 
Vegetable          .         f      I,  2 

Ethyl,  Bromide 
Chloride    . 

139 
140 

Dry  Wines            »  v     132-133 

Hydrate    . 

124 

Duboisine    .         .  "'      .        37 

Eucaine 

303 

Duotal         .         .       '  »"     152 

Eucalyptol  . 

200 

Eucalyptus  . 

199 

Eudoxin       ,     \  . 

303 

Ecbolics       .       .  »         .    6,  35 

Eugenol 

303 

Effects  of  Drugs  .      '  ,  V  .        4 

Eupatorium. 

215 

Primary   .          ^          .          4 

Euphthalmin 

303 

Secondary          .   ''\     .          4 

Europhen     . 

I 

06,  303 

Effervescent  Magnesium 

Evacuants  . 

7 

Sulphate        .          .        61 

Exalgine 

162 

Elaterin        .         .        202,  203 

Excitomotors 

7 

Elaterinum             .        202,  203 

Exodyne 

1  60 

Elaterium    .          .       202,  203 

Expectorants 

7 

28,29 

Electro-Therapeutics  and 

Extracta 

9 

Radiology      .        288-292 

Extract  of: 

Elixiria                  .P                    9 

Belladonna  Leai 

es 

229 

Elixirs                     .    .                 9 

Colocynth 

202 

Emetics        ,         .     6,  29,  275 

Gentian     . 

224 

Emetine                 .                212 

Nux  Vomica 

223 

Emmenagogues     .              6,  35 
Emollients             .'           7,37 
Emplastra             .        '.         9 

Opium 
Physostigma 
Stramonium 

178 
197 
230 

322 


INDEX. 


PAGE 

PAGE 

Extracts       .         ;       9,  II 

.  J9 

Goto         .         . 

241 

Extractum: 

Digitalis  . 

236 

Belladonna  Foliorum 

229 

Ergot        . 

259 

Colocynthidis     .         . 
Compositus     .          . 

202 
202 

Eucalyptus 
Gelsemium 

200 

220 

Gentiancs  .                   . 

224 

Gentian     . 

224 

Nucis  VomiccB  .        ,  . 

223 

Ginger 

245 

Opii          ,       '   .          . 

178 

Grindelia  . 

216 

Physostigmatis  . 
Stramonii           .         . 

197 
230 

Guarana  . 
Hydrastis  . 

185 
171 

Eye     . 

37 

Hyoscyamus 

232 

Indian  Cannabis 

246 

Faradism     .          .        .  . 
Febrifuges    .          .          .    , 

289 

7 

Ipecac 
Lobelia 

211 
217 

Ferratin       .                 -  . 

303 

Lupulin    . 

247 

Ferri  et  Quinines  Citras  . 

78 

Nux  Vomica 

223 

Ferri  Hydroxidum.         .."'.. 

78 

Phytolacca 

253 

Ferri    Hydroxidum  cum 

Pilocarpus 

192 

Magnesii  Oxido 
Ferri  Hypophosphis 

79 
97 

Podophyllum 
Rhubarb    . 

I69 

238 

Ferri  Phosphas 

78 

Rubus 

199 

Ferri  Sulphas  Granulatus 

78 

Sarsaparilla  Comp.     . 

251 

Ferric  Hydroxide  . 

78 

Senega 

185 

Ferric    Hydroxide    with 

Senna 

198 

Magnesium  Oxide    . 
Ferric  Phosphate  . 

79 
78 

Serpentaria 
Spigelia    . 

240 
218 

Ferrum         . 

73 

Squill 

251 

Reductum.          .         „ 

77 

Taraxacum 

215 

Filix  Mas     .         .' 

260 

Valerian   . 

214 

Filtration     . 

41 

Veratrum  Viride 

255 

Flaxseed 

187 

Viburnum  Prunifolium 

206 

Poultice    .          .         . 

188 

Fluidextracta 

9 

Tea           .          .       '  .    ' 

187 

Fluidextracts.         9,  10,  18 

i  J9 

Flexible  Collodion. 

189 

Fluidextractum  : 

Flowers  of  Sulphur 
Fluidextract  of: 

107 

Aconiti 
BelladonncB  Radicis     . 

167 

229 

Aconite     .         .         . 

167 

Buchu 

190 

Belladonna  Root 

229 

Calumbae  . 

172 

Buchu       .         •  '.._.. 

190 

Cannabis  . 

246 

CaJumba  .          , 

172 

CascarcR  Sagrada 

193 

Cannabis  . 

246 

CimicifugcB 

170 

Cascara  Sagrada 

193 

Cinchonce  . 

207 

Cimicifuga         . 

170 

Colchici  Seminis 

258 

Cinchona 

207 

Conii 

205 

Colchicum  Seed.          . 

258 

Convallarias       .          ; 

253 

Conium    .          ,          . 

205 

Goto 

241 

Convallaria        .          . 

253 

Digitalis   . 

236 

INDEX. 


323 


PAGE 

Fluidextractum  —  Contin  ued 

PAGE 

Gin     .          .         .      ,  .      132 

Ergota      . 

259 

Ginger          . 

245 

Eucalypti.          . 
Gelsemii    .         ,         ,. 

200 
220 

Glonoin        .         »    , 
Glucosides  .         . 

147 
7 

Gentiana  .         . 

224 

Glutol          .         .         . 

304 

Grindelia  .          .         . 

216 

Glycerin 

163 

Guarana  .         , 

185 

Glycerinum  . 

163 

Hydrastis.      ..'•».         . 

171 

Glycerita 

9 

Hyoscyami         .  '.    .'.. 

232 

Glycerite  of: 

Ipecacuanha      . 

211 

Boroglycerin 

164 

Lobelia     .         . 

217 

Phenol      . 

164 

Lupulini  . 

247 

Tannic  Acid      .        118, 

164 

Nucis  Vomica  .      /  , 

223 

Glycerites    .          .          .9 

,  10 

Phytolaccae 

253 

Glyceritum  : 

Pilocarpi            .          . 

192 

Acidi  Tannici    .        118, 

164 

Podophylli 
Rhamni  Purshiana     . 

I69 
193 

Boroglycerini 
Phenolis    . 

164 
164 

Rhei 

238 

Glycerol        '. 

163 

Rubi     t.      .    .;';. 

199 

Glycyrrhiza  . 

195 

Sarsaparilla  Comp  .  . 

251 

Gold   .... 

67 

Scilla       ,          .         . 

251 

and  Potassium    Bro- 

Senega    ...... 
Senna       ... 

Iff 

mide     . 
and  Sodium  Chloride  . 

68 
67 

Serpentanae       .     ...  . 

240 

Chloride  . 

68 

Spigelia    . 
Stramonii.         f 

218 

230 

Preparations 
Golden  Seal 

67 
170 

Taraxaci  .          . 
Valerianse          ..        '. 

215 
214 

Physiological  Actions 
Preparations 

171 
171 

F^ra/n  Viridis 

255 

Gossypium  Purificatum  . 

189 

Viburni  Prunifolii 

206 

Goulard's  Cerate  . 

65 

Zingiberis.         .  .    .    . 

245 

Goulard's  Extract  . 

65 

Formaline    . 

124 

Granatum 

200 

Fowler's  Sol.  of  Arsenic. 

90 

Granulated  Ferrous  Sul- 

Friar's Balsam 

218 

phate     . 

78 

Griffith's  Mixture 

77 

Galactagogues      .          . 

7,  35 

Grindelia 

216 

Gallic  Acid  . 

118 

Guarana       ... 

185 

Galvanism   . 

288 

Guaiacol       . 

152 

Gastric  Sedatives  . 

3° 

Carbonate  . 

IS2 

Tonics 

30 

Guaiacolis  Carbonatis     . 

IS2 

Gelsemium    . 

219 

Gums           .          .         . 

2 

General  : 

Gun  Cotton            .         . 

189 

Anaesthetics 

33 

Gunjah        .        t,^ 

245 

Anodynes       .    .         . 

33 

Generative  Organs 

35 

Habit 

3 

Gentian         .         , 

224 

Hsematinics. 

38 

Gentiana       .          .,   , 

224      Haemogallol.          . 

304 

324 


INDEX. 


Haemoglobin 

Haemostatics 

Hashish 

Helmitol      . 

Hemol 

Henbane       .         .         . 

Heroin 

Hexamethylenamine 

Hoffman's,  Anodyne     . 

Drops 
Holocain 
HomatropincB  Hydrobro- 

midum 
Homatropine    Hydrobro- 

mide 

Honey  of  Rose 
Hops  . 
Humulus 
Hydracetin 
Hygragogues 
Hydrargyri: 

Chloridum  Corrosivum 
Mite 

lodidum  Flavum 
Rubrum 

Salicylas 
Hydrargyrum 

Cum  Creta 
Hydrastinince        Hydro- 

chloridum 

Hydrastinine        Hydro- 
chloride 
Hydrastis     . 

Fluidextract  of  . 

Tincture  of 
Hydrated  Chloral  . 
Hydrochloric  A  cid 
Hydrocyanic  Acid 

Physiological  Actions. 

Symptoms  of  Poison- 
ing 

Treatment  of  Poisoning 
Hydronaphthol     . 
Hydrous  Wool  Fat 
Hyoscine  Hydrobromide 
Hyoscyamine        Hydro- 
bromide 


PAGE 
304 

PAGE 

Hyoscyamus          .         .231 

7,37 

Hyonone      .          .          .144 

245 

Hypnotics    .          .         4,  7,  33 

3°4 

Hypodermics         .          .         19 

304 

Administration        of 

231 

Drugs  .          .        278-280 

182 
3ii 

Hypophosphites    .          .        97 
Hypophysis  Sicca  .         .      268 

138 

Hysteria      .         .         .      222 

138 

304 

Ichthyol       .          .         .108 

229 

Idiosyncrasy         .          .          3 

Indian  Tobacco     .         .      216 

229 

Infusa          ...          9 

306 

Infusion  of: 

246 

Adonis  Vernalis          .      170 

35 

Digitalis            .         .      236 
Senna,  Compound       .      198 

5,3i 

Infusions      .          .       9,  18,  20 

Inhalations  .          .          .        29 

82 

Inorganic  Acids    .          .109 

84 

Intestinal^  ^Antiseptics    .        31 

84 

Inunctions  .          .          .         18 

84 

Iodine          .         .         .      101 

84 

Compound  Solution  of      103 

80 

Incidental  Effects       .       102 

85 

Ointment  .          .          .104 

171 

Physiological  Actions       101 
Preparations      .          .102 

Tincture  of        .         .103 

171 

lodoform       .          .          .104 

170 

Derivatives       .          .106 

171 

Ointment  .          .          .105 

171 

lodoformogen       .          .      304 

140 

lodoformum           .         .104 

in 

lodol  .                                   105 

119 

lodolum                 .          .105 

I2O 

lodophenine          .          .162 

lodothyrin             .          .      304 

121 

lodum                    .         .      101 

121 

Ion  Action             .          .        41 

156 

Ipecac                    .         .      210 

262 

and  Opium  Powder  180,  211 

232 

Physiological  Actions       210 

Preparations      .          .      211 

232 

Ipecacuanha          .       210,  276 

INDEX. 

325 

PAGE 

PAGE 

Iron    .         .         f  ••'.. 

73 

Treatment  of  Poison- 

Absorption < 

74 

ing    ....  .  •       «.•.      » 

64 

Administration 

75.  76 

Lecithin 

305 

and  Ammonia,  Solu- 

Levant Wormseed 

214 

tion  of  Acetate  of     . 
and  Quinine  Citrate    . 

76 

78 

Licorice  Root         . 
Lily  of  the  Valley 

195 
252 

Dialyzed  . 

79 

Lime  ....  57,  58 

Incidental  Effects 

75 

Liniment  . 

59 

Mixture,  Compound    . 

77 

Milk  of    . 

Physiological  Actions 
Pills  of  Aloes  and 

73 

78 

Preparations   '  .      .    . 
Syrup  of 

59 

Preparations     . 

75 

Water       . 

58 

Quevenne's 

77 

Linimenta    .         «•         * 

9 

Reduced    . 

77 

Liniment: 

Saline  Combinations 

75 

Aconite    .         .-  . 

1  68 

Irritants      v  .   •  +,-•/. 

36 

Ammonia.       \         . 

57 

Camphor  .         «  ..••',' 

239 

Jaborandi    . 

190 

Chloroform         .          . 

135 

Jalap 

224 

Chloroform,        Com- 

Jalapin 

224 

pound  .         .   •      . 

135 

Jambul 

20  1 

Lime        .         .         • 

59 

Jamestown  Weed  . 

230 

Soap 

239 

Jequirity 

304 

Liniments    .          .         .„ 

9,  ii 

Juniper  Oil  .          .         « 

249 

Linimentum,  Aconiti 

168 

AmmonicB          .         . 

57 

Kola   .          . 

305 

Colds 

59 

CamphorcB 

239 

Labarraque's  Solution     . 

98 

Chloroformi 

135 

Lactic  Acid  . 

119 

Choroformi  Composi- 

Dilute 

119 

tum      .         .        •*- 

135 

Lactic  Acid  Bacilli         . 

269 

Saponis  .»    .     *  -      i  » 

239 

Lactose         .          .         „ 

262 

Linseed        ..         . 

187 

Lady  Webster  Pill 

252 

Linum 

187 

Lamellae      v        .         . 

12 

Liquor,  Acidi  Arsenosi  . 

90 

Lanolin        .          .          . 

262 

Ammonii  Acetatis    \  .. 

56 

Lard             .         .         . 

263 

Arseni  et  Hydrargyri 

Laudanum   .         .         ,, 

179 

lodidi   .         . 

9i 

Laughing  Gas 

57 

Calcis 

58 

Laxatives     .         .        -. 

5,  30 

Digitoxin  Solubilis 

237 

Lead    .         .         .         * 

61 

Fern  et  Ammonii  Ace- 

Acetate    .         .         . 

64 

tatis 

76 

Physiological  Actions 

61 

Ferri  Subsulphatis 

77 

Plaster      .         .         -, 

65 

Tersulpliatis  . 

77 

Poisoning           .   -     '. 
Preparations      .          . 

62 

64 

Formaldehydi     . 
Hydrogenii  Dioxidi     . 

124 
1  08 

Subacetate,  Cerate  of  . 

65 

lodi  Compositus      .    1 

103 

Solution  of     .         » 

65 

Magnesii  Citratis      .  * 

.61 

326 


INDEX. 


PAGE 

Liquor  —  Continued 

Plumbi  Subacetatis     . 

65 

Potassii  Arsenitis       « 

90 

Hydroxidi       .         ,• 
Soda  Chlorinate         . 

94i 

Liquores      .         .        ;  . 

9 

Listerine 

305 

Lithium       «    '    •  *         .41 

»53 

Bromide    .         «         54, 

IOO 

Carbonate  .         •         . 

54 

Citrate      .         .  '       . 

54 

Litmus  Paper        ,         , 

305 

Liver  of  Sulphur    .         . 

107 

Lobelia 

216 

Local  : 

Anaesthetics       .         . 

33 

Anodynes          « 

33 

Losophane  .         •.        106, 

305 

Lozenges      .         .         .    9 

,  ii 

LugoVs  Solution    . 

103 

Lunar  Caustic       .  '      . 

67 

Lupulin        *         .         . 

247 

Lupulinum  .          .         . 

247 

Lycopodium  .         ,         » 

260 

Lysoform     .         «       •  .•' 

305 

Lysol            .         .         . 

305 

Madeira 

133 

Magendie's  Solution  of 

Morphine      .         . 

181 

Magma  Bismuthi  . 

305 

Magma  Magnesia          . 

305 

Magnesia     .         .         >.  "• 
Physiological  Actions 

60 
60 

Preparations      .      -  >. 

60 

Magnesii: 

Oxidum    -.         .         . 

60 

Sulphas    .         -.         '.  - 

60 

Effervescens  .         .   ' 

61 

Magnesium           .         .  - 

60 

Citrate,  Solution  of    V 

61 

Oxide        .         .         . 

60 

Sulphate  .      ^  .         . 

60 

Effervescent  .         . 

61 

Male  Fern    .          .    •      .  ' 

260 

Mandrake    .          ;  v       , 

168 

Manganese  .     '•    .  '      V  !l 

79 

PAGE 

Physiological  Actions        79 
Preparations     .         .        79 
Manganese  Sulphate     .        80 
Manganesium       .         .        79 
Mangani  Sulphas.          .        80 
Marrubin     .          .          .      305 
Massa  Hydrargyri          .        85 
Materia     Medica,     In- 
organic.         .         .        40 
May  Apple  .         .      168 

Medicine  I 

Modes  of  Applying  .  18 
Mel  Rosa  .  .  .306 
Menthol  .  .  .  237 
Mercurial  Ointment  .  85 
Mercuric  Salicylate  .  84 
Mercury  .  .  80,  280 
Biniodide  of  .84 

Physiological  Actions  81 
Preparations  .  .  82 
Protiodide  of  .84 

Symptoms  of  Poison- 
ing       .          .         ;        8l 
Treatment  of  Poisoning     82 
with  Chalk      .         .        85 
Metachloral          .          .143 
Metals,  The          .          .        61 
Methacetin  .        162,  306 

Methylal      .  .      306 

Methylene  Blue  .  .  306 
Methyl  Hydrate  .  .  124 
Methylmorpliine  .  .182 
Methyl  Salicylate  .  .  244 
Methylthionine  Chloride.  306 
Metric  System  .  .  21 
Microcidin  .  .  .156 
Migranin  .  .  .  306 
Mild  Mercurous  Chloride  84 
Milk  of  Bismuth  .  .  305 
Milk  of  Lime  .  .  59 
Milk  of  Magnesia  .  .  305 
Mineral  Waters  .  293-297 
Mistura : 

Asafetidae          .          .      206 

Crete        .         .          .59 

Ferri  Composita         .        77 

Misturse       ...          9 


INDEX.                                       327 

PAGE 

PAGE 

Mitigated  Caustic          .        67 

Convolvulaceas  . 

224 

Mitigated  Silver  Nitrate       67 

Cruciferae 

183 

Mixture  of: 

Cucurbitaceae    . 

201 

Asafetida          •....        .      206 

Erythroxylaceae 

185 

Chalk        .         .         .        59 

Euphorbiaceae   . 

241 

Iron,  Compound         .        77 

Filices      . 

260 

Mixtures      .         .          .    9,  10 

Fungi 

260 

Monkshood            .          .       165 

Gentianaceae     . 

224 

MonseVs  Solution           .        77 

Graminaceaa 

258 

Morphina     .          »;         .      180 

Labiatae    . 

237 

Morphines,    .         '.i         .       180 

Lauraceae  . 

238 

Chloride    .          .      ..  .  .       181 
Compositus,  Pulvis    .      181 

Leguminosas      . 
Liliaceae    . 

193 
250 

Hydrochloridum.         ,       181 

Linaceaa    .          , 

187 

Sulphas    .          .         .180 

Loganiaceae        , 

218 

Tinctura  Chloroformi 

Lycopodiaceae   . 

261 

et  Morphinae.          .       181 

Malvaceae 

189 

Morphine     .       .  .        180,  279 

Menispermaceag 

171 

Hydrochloride    .          .       181 

Moraceae  . 

246 

Powder,  Compound  .      181 

Myrtaceae 

199 

Sulphate  .          .          .180 

Oleaceae    . 

218 

Tincture    of    Chloro- 

Papaveraceae    . 

173 

form  and  Morphine      181 

Phytolaccaceae  . 

253 

Motor  Depressants        .        32 

Polygalaceae 

184 

Motor  Stimulants          .        32 

Polygonaceae     . 

238 

Mucilages    .         ,         .    9,  10 

Ranunculaceas  . 

165 

Mucilagines  .         .         .          9 

Rhamnaceae      „    ' 

193 

Mustard       .          .   ^     183,  275 

Rosaceae  .         „ 

198 

Physiological  Actions       183 

Rubiaceae.       .  f 

206 

Mydriatics  .          r  •  ...     .    7,  37 

Rutaceae  .         ,  ; 

190 

Myotics       .         ,   '      .    7t  37 

Salicaceae  . 

244 

Myrrh          f         „,         .       193 
Myrrha        .         f         .      193 

Sapindaceae 
Scrophulariaceae 

185 

233 

Simarubaceae    » 

192 

Naphthalin  .         ...        .      156 

Solanaceae 

226 

Naphthalenum      .         .      156 

Sterculiaceae      . 

190 

Naphthol     .      •    .         .      156 

Styracaceae        f 

217 

Narcotics     .         .         •    7»  33 

Ternstromiaceae 

213 

Natural  Orders: 

Umbelliferae 

203 

Apocynaceae      .         .      225 

Valerianaceae     . 

213 

Aristolochiae      ..  ,      .      240 

Zingiberaceae     . 

245 

Burseraceaa        .'         .      193 

Nervous  System  . 

32 

Byttneriaceae     .          .190 

Neurotics     . 

7 

Campanulaceae  .          .      216 

Nicotine       . 

233 

Caprifoliaceae    .          .      206 

Nitrate  of  Silver     . 

65,66 

Compositae        .        214,  260 
Coniferae  .         .   .      .      247 

Nitric  Acid  . 
Physiological  Actions 

no 
III 

328 


INDEX. 


PAGE 

PAGE 

Nitric  Acid  —  Continued 

Theobroma 

190 

Poisoning    and   Anti- 

Turpentine, Reel. 

249 

dotes     .        ..         .      ill 

Vitriol      . 

109 

Preparations     .        ..      Ill 

Wintergreen 

244 

Nitroglycerin       ..  .  •  •  *      147 

Oils     .     '    . 

2 

Nitroglycerinum  .          .147 

Ointment: 

Nitrohydrochloric  Acid  .       112 

Ammoniated  Mercury 

86 

Nitrous  Oxide  Gas         .        57 

Boric  Acid 

114 

Non-Metallic  Elements.        94 

Chrysarobin 

306 

Norwood's  Tincture       .      255 

Diachylon 

65 

Novaspirin  .                   .      306 

Mercurial 

85 

Novocain     .                   .      306 

Nitrate 

86 

Nuclein       .                  .      306 

Stramonium 

230 

Nutriants     .                   .          7 

Yellow  Mercuric  Oxide 

86 

Nutrients     .                   .7 

Veratrine  . 

256 

Nux  Vomica                   .      220 

Ointments    . 

9,  ii 

Extract     .                   .      223 

Oleata 

9 

Fluidextract                 .      223 

Oleate  of: 

Physiological  Actions       220 
Preparations      .       .  ''.      223 

Mercury   . 
Veratrine  . 

163 
256 

Sympt.  of  Poisoning  .      221 

Oleates 

9,  10 

Tincture  .         ..        .      223 

Oleatum: 

Hydrargyri     -—  r- 

163 

Odorous  Principles         .          2 

Veratrinae 

256 

Oil  of: 

Oleic  Acid    . 

163 

Allspice    .      .             .      249 

Oleoresinae   . 

9 

Anise       .                   .  -    249 

Oleoresins    . 

9,  10 

Betula       .                   .      244 

Oleum: 

Camphor  .             .      .      240 

A  nisi 

249 

Caraway  .                   ,      249 

Aurantii  . 

249 

Cod  Liver             -    "  .      264 

Betula      . 

244 

Coriander                     .      249 

Camphorae 

240 

Eucalyptus           -        .200 

Cari 

249 

Fennel      .                   .      249 

Chenopodii 

249 

Gaultheria            ;      155,  244 

Coriandri           . 

249 

Juniper    .                   .      249 

Eucalypti 

200 

Lavender  .                   .      237 

Fosniculi 

249 

Lemon      .  .                 .      249 

Gaultherics         .        15 

5,244 

Nutmeg     .            -       .      249 

Juniperi  . 

249 

Olive         .                   .      218 

Lavandulcs 

237 

Orange      .                  .  -    249 

Limonis    . 

249 

Peppermint          .        .      237 

Menthce  Piperitce 

237 

Rosemary  .                   ,      249 

Morrhuee  . 

264 

Rue           .                   .190 

MyristiccB. 

249 

Sassafras  .                   .      249 

Oliva 

218 

Sweet  Birch                 .      244 

Picis  Liquid®  Rect.     . 

247 

Tar,  Rectified             .      247 

Pimenta  . 

249 

INDEX. 


329 


Oleum  —  Continued 

PAGE 

Pepper 

PAGE 
232 

Ricini       .         .,         . 

242 

Peppermint  . 

237 

Rosmarini         .         . 

249 

Water       . 

237 

Sabince     .                   . 

249 

Pepsin         .         .-; 

262 

TerebinthincB  Rect.      * 

247 

Pepsinum    . 

262 

Theobromatis    '.         . 

190 

Peronin 

307 

Tiglii       .•        v         'i' 

241 

Peroxide  of  Hydrogen 

108 

Olive  Oil       .         *;       . 

218 

Peruvian  Bark 

206 

Opium 

173 

Petrolatum   . 

163 

Camphorated  Tincture. 

Pharmacopoeia 

8 

Compound  Tincture  . 

1  80 

The  New 

vii 

Extract     . 

178 

Phenacetin   . 

161 

Incidental  Effects  of  . 

178 

Phenocoll  Hydrochloride 

162 

Physiological  Actions 

173 

Phenol 

148 

Pills  of     . 

178 

Phenolid      .         .    .      . 

160 

Powder,  Ipecac  and    . 

1  80 

Pheno-Resorcin     . 

161 

Preparations 

178 

Phenylis  Salicylas. 

154 

Symptoms  of  Poison- 

Phenyl Salicylate  . 

154 

ing 

175 

Phosphates 

41 

Tincture  of         .         . 

179 

Phosphoric  Acid    . 

Ipecac  and 

1  80 

Diluted     . 

H3 

Treatment  of  Poison- 

Phosphorus . 

94 

ing        .      -.         . 
Orexin          .         * 

176 

307 

Physiological  Action  . 
Pills  of     . 

95 
97 

Organic  Acids 

114 

Preparations 

97 

Iron 
Materia  Medica 

74 
165 

Treatment  of  Poisoning 
Physostigma. 

96 
196 

Osmosis        .         >,;•     '    . 

Extract     . 

197 

Ovarian  Extract  . 

268 

Tincture             . 

197 

Oxalic  Acid           . 
Oxide  of  Zinc         .          ; 

122 

70 

Physostigmine       . 

Salicylate  .          . 

196 
197 

Oxygen         ,          .          . 

307 

Phytolacca  . 

253 

Oxytocics     ... 

7,35 

Picric  Acid  .          .  v' 

307 

Picrotoxin    .          . 

172 

Pancreatin   .         .         ; 

263 

Picrotoxinum        . 

172 

Papers          .          .         • 

9,  ii 

Pills    .... 

9i  ii 

Paraldehyde.          .          . 

143 

Pills  of: 

Paraldehydum       . 

143 

Aloes        .         .         . 

252 

Parasiticides          .  ,        « 

39 

Asafetida  . 

205 

Paregoric      .          .          . 

179 

Compound  Cathartic    . 

202 

Paris  Green.          ; 

Ferrous  Carbonate 

77 

Pelletierine  .          . 

200 

Ferrous  Iodide  . 

78 

Pelletierine  Tannate 

2OI 

Opium      .          .          . 

178 

Pellitory  Root 

26O 

Phosphorus 

97 

Pellotine 

307 

Vegetable  Cathartic  . 

202 

Pental          .      '  ; 

307 

Pilocarpince  Hydrochlor- 

Pepo  .... 

203 

idum     .         . 

192 

33°                                    INDEX. 

PACE 

PAGE 

Pilocarpine  Hydrochlor- 

Bicarbonate       .         .        44 

ide 

[I92 

Bitartrate           .         .        49 

Pilocarpus   . 

190 

Bromide   .         .          .        99 

Pilules. 

9 

Carbonate.         .         .        44 

Aloes 

252 

Chlorate    ...        46 

Asafatidce 

205 

Chloride    ...        42 

CatharticcR  Composites 

202 

Citrate      ...        46 

Catharticae  Vegetabil 
Ferri  Carbonatis 

3S     2O2 

77 

Cyanide   ...        48 
Hydroxide          .          .  42,  45 

Ferri  lodidi 

78 

Hypophosphite  .          .        97 

Opii 

178 

Iodide       .          .          .102 

Phosphori 

97 

Nitrate      .         .         .        49 

Pink  Root    . 

218 

Permanganate    .          .        79 

Piperazine    . 
Piqures 

308 
280 

Poisoning  by     .          .  43,  47 
Preparations      .          .        44 

Pix  Liguida          , 

247 

Treatment  of  Poison- 

Plasters 

9f  IJ 

ing        ...        44 

Plumbi  Acetas 

64 

Powdered  Ipecac  .          .      211 

Plumbum     . 

61 

Powders       .          .          .    9,  n 

Podophyllum 

166 

Prepared  Chalk     .          .        59 

Poisons 

270 

Proof  Spirit.          .          .      131 

A  Table  of 

2 

71-274 

Prophylactics        .          .          7 

Poke  . 

253 

Protargol     .          .      .          308 

Pomegranate          , 

200 

Protectives  ...        37 

Porter 

133 

Protiodide  of  Mercury    .        84 

Port  Wine    . 

I32 

Prunus  Virginiana         .       199 

Potash 

43 

Prussic  Acid          .         .      119 

Potassa  SulphuraU 

\ 

107 

Pulmonary  Sedatives     .        28 

Potassii: 

Pulveres       ...          9 

Acetas       .         < 

46 

Pulvis: 

Bicarbonas 

44 

Aromaticus        .         .      240 

Bitartras  . 

49 

Effervescens  Compositus      53 

Bromidum 

99 

GlycyrrhizcB  Compositus    195 

Carbonas  . 

44 

Ipecacuanhas     .          .      211 

Chloras 

46 

Ipecacuanha  et  Opii  180,  211 

Citras 

46 

JalapcB  Compositus     .      225 

Cyanidum 

48 

Morphinae  Compositus     181 

et  Sodii  Tartras 

50 

Pumpkin  Seed       .         .      203 

Hydroxidum 
Hypophosphis 
lodidum   . 

45 
87 

102 

Purgatives   .           5,  30,  31,  42 
Purified    Antidiphtheric 
Serum               .          .      269 

Nitras       , 

49 

Pustulants             .          .        36 

Permanganas 

79 

Pyramidon            .          .      308 

Potassium    . 

4i>43 

Pyrethrum              .          .      260 

Acetate 

46 

Pyridine                 .         .162 

Action  of 

43 

Pyrogallol               .          .      308 

and  Sodium  Tartrate 

50 

Pyroxylinum         .         .189 

INDEX. 


331 


Quassia        .         .  192 

Tincture  of        *  192 

Queyenne's  Iron    .          ,  77 

Quicksilver   .          *  80 

Quinina        .          .          «  207 

Incidental  Effects  209 

Official  Preparations  of  209 

Physiological  Actions  208 

Quinine        .          .        206,  207 

and  UreaHydrochloride  209 

Rabies  Antitoxin  .  .284 
Radiology  .  .  288 
Radium  .  .  .  292 
Raspail's  Sedative  Water  57 
Rectified  Oil  of  Turpen- 
tine .  .  .  249 
Red  Bone  Marrow  Ext.  286 
Red  Iodide  of  Mercury  .  84 
Reduced  Iron  .  .  77 
Red  Wine  .  ...  132 
Refrigerants  .  .  7,  29 
Renal  Diuretics  .  .  34 
Resina  Podophylli  .  169 
Resinae  .  .  .  9 
Resins  .  ^  .  9,  n 
Resorcinol  .  .  .160 
Respiratory,  Depressants  28 
Stimulants  .  '  .  28 
System  .  -".  .  28 
Restoratives  .,  .  38 
Revulsants  .  7 
Rhamnus  Purshiana  .  193 
Rheum  .  „  .  238 
Rhubarb  .  .»  238 
Rhus  Toxicodendron  .  216 
Rochelle  Salt  ...  .  50 
Rosin  Plaster  .  v  65 
Rubefacients  .,  .  7,  36 
Rubus  »  '..  .  199 
Rue  ...  ,  190 
Rum  .  .  .  .  132 
Ruta  Graveolens  .  .  .  190 


Saccharin 
Saccharum  Lactis 
Sacred  Bark 


162 
262 
193 


Saleratus     .•        .  .  44 

Salicin          .          .  155,244 

Salicinum    .         .  155,  244 

Salicylic  Acid        .  .  152 

Saline  Purgatives.  .  31 

Salines          .         .  .  5,  42 

Salipyrin      .,        .    '  .  308 

Salol   .         . ,       . .  '  .  154 

Salophen      . ,        . .  .  308 

Salt     .         .         .  51, 276 

Epsom      .         . .  .  41,  60 

Rochelle    .         .  .  50 

Salt,  Action.         . .  .  41 

of  Tartar           ".  .  44 

Saltpetre       .         .  .  49 

Salt  Solution,  Normal  .  279 

Salts   .          .         . :  .  17 

Salvarsan     .         .  •  3°8 

Sanatogen    .          „-.  .  309 

Sanitas         .       :  .   •  .  249 

Santonica    . .       * .  .  214 

Santonin      .        . .  .  214 

Saponin        .          **  .  251 

Sarsaparilla          .,  .  251 

Sarsaponin            .  .  251 

Saturated  Solution  .  13 

ScammonifB  Radix  .  224 

Scammony,  Resin  .  .  224 

Scammony,  Root    .  .  224 

Scilla  .         .         f$.&'  ;  250 

Scoparius     .,         .  .  194 
Scopolamine     Hydrobro- 

mide       .         .  .  232 

Sedatives     .         .^  .  ,       8 

Seidlitz  Powder      ;,  ;  53 

Senega          .          .  .  184 

Senna           .         .,  .  197 

Confection  of     .  .  198 

Fluidextract  of  .  .  198 

Infusion,  Compound  198 

Syrup  of  .         .  .  198 

Sera    .     _    .          . '-  .  282 

Serpentaria  .          4  '  •  .>  240 

Serum: 

Antidiphthericum  .  268 

Siccum  .  .269 

Antiplague        .  .285 


332 


INDEX. 


PAGE 

Serum  —  Continued 

Solubes     .          .          .12 

Antipneumococcus     .      286 

Soluble  Gun  Cotton     .      189 

Antistreptococcus       .       286 

Solution  of: 

Antitetanicum    .          .-      284 

Ammonium  Acetate    .        56 

Antityphoid      .          .      285 

Arsenous  Acid  .         .        90 

Antivenine        .          .286 

Arsenous    and    Mer- 

Tubercular       .         .285 

curic  Iodide    .          .        91 

Therapy  .         .          .281 

Chlorinated  Soda         .        98 

Sherry          .         .          .133 

Ferric,  Subsulphate     .        77 

Sialogogues            .          .    8,  29 

Sulphate         .         .        77 

Silver            ...        65 

Formaldehyde    .          .124 

Nitrate      ...        65 

Hydrogen  Dioxide       .       108 

Fused    ...        67 

Iron  and  Ammonium 

Mitigated       .          .        67 

Acetate           .         .        76 

Physiological  Actions         66 

Lead  Subacetate           .        65 

Symptoms  of  Poison- 

Magnesium Citrate     .        61 

ing        .         ...        66 

Potassium  Ar  senile     .        90 

Simple  Purgatives          .;      31 

Hydroxide      .          .        45 

Simple  Syrup        .         .        10 

Solutions      .          .          .    9,  10 

Sinapis  Alba  and  Nigra       183 

Notes  on  .          .          .  12-14 

Skin    .         ...       .        36 

Problems  .          .          .  14-17 

Snake-Root  .          .        184,  240 

Somatose    ".         .         .      309 

Soap  Liniment      .         .239 

Somnal         .        -yr-     .      309 

Plaster     .         .          .65 

Somnifacients       .          .          8 

Suds         .          .         „      276 

Soporifics     .          .          .    8,  33 

Soda   .         .         .;..       .,       50 

Sorbefacients        .          .          8 

Physiological  Actions         51 

Sozal  ....      106 

Sources     .         .         .  .      50 

Sozoiodol     .          .          .106 

Sodii: 

Spanish  Flies        .         .      265 

Bicarbonas         .         .        52 

Sparteine  Sulphate         .      194 

Boras        .          .         .53 

Specifics       ...          8 

Bromidum         .         .      100 

Spermaceti   .          .          .      264 

Carbonas           .         *-      52 

Spigelia        ...          .          .      218 

Chloridum         .         .        51 

Spinal  Depressants        .        32 

Hydroxidum      ."•'•.        .        50 

Spinal  Stimulants          .  .      32 

Hypophosphis    .         .        97 
Salicylas  .         .         .154 

Spirit  of: 
Camphor  .                   .      239 

Sodium         .          .          .  41,  50 

Chloroform                  .      135 

Bicarbonate        .         .        52 

Ether        .                   .138 

Borate      .         .         ..      53 

Glyceril  Trinitrate      .      147 

Bromide   .         .         ,      100 

Lavender  .                   .      237 

Cacodylate          .          .301 

Mindererus                  .        56 

Carbonate         .          .  42,  52 

Nitroglycerin               .      147 

Chloride    .          .          .  42,  51 

Nitrous  Ether              .      138 

Hydroxide          .          .42,50 

Spirits          .                 9,  10,  20 

Hypophosphite  .          .        97 

Spiritus        .                   .          9 

Salicylate           ,v       .      154 

dZtheris    .                  .      138 

INDEX. 


333 


PAGE 

Spiritus  —  Continued 

PAGE 

Sulphur       .         .         .106 

Compositus   . 

138 

Liver  of    .         .         .107 

Nitrosi         ..  «,. 

138 

Lotum       .     ,  .  t         .      107 

Ammonia  Aromaticus 

56 

Ointment  .         .         .107 

Camphor  a        „  i  .•.-.•, 

239 

Sublimatum      ...        .      107 

Chloroformi 

135 

Sulphuric  Acid     .=.        .      109 

Frumenti 

Aromatic  .         >"      •      no 

Glycerilis  Nitratis 

J47 

Diluted     .         .         .110 

Lavandula       .  .        >, 

237 

Physiological  Actions       109 

Tenuior    .          .         , 

Poisoning           .          .109 

Vini  GalUci        .        . 

131 

Sulphurous  Acid  .          .       113 

Spotted  Hemlock. 

203 

Suppositoria      .   .  !        .          9 

Squibb  's  Mixture.       .  4 

180 

Suppositories        .          .   9,  12 

Squill 

250 

Suprarenals,  Dried         .      268 

Staphisagria 

168 

Suprarenalum  Siccum    .      268 

Starches                 . 

2 

Sweet  Spirit  of  Nitre      .       138 

Stavesacre 

168 

Sweet  Wines         .          .133 

Sterules        . 

12 

Syrupi          ...          9 

Stimulants            .  • 
Stomachics            . 

8 
8 

Syrup  of: 
Calcium  Lactophosphate     59 

Stomach-tube 

275 

Ferrous  Iodide  .          .         76 

Stout 

133 

Hypophosphites  .         .        97 

Stramonium           .     •   ., 

230 

Ipecac                .         .      211 

Strophanthin 

225 

Rhubarb              .          .      238 

Strophanthus 

225 

Sarsaparilla,  Compound    251 

Strychnine   .      .    *       a 

20,  279 

Senega               .         .185 

Nitrate      . 

223 

Senna        .,        ,  .        .      198 

Precautions      •  + 

222 

Squill         .      .;«•.:•     .      251 

Preparations      . 

223 

Tar                    .         .      247 

Sulphate 

223 

Syrups           ;        •       9»  Jo»  20 

Symptoms  of  Poisonii 
Treatment  of  Poison- 

Ig   221 

Syrupus: 
Calcii  Lactophosphatis        59 

ing 

222 

Ferri  lodidi       .          .        76 

Stypticin 

309 

Hypophosphitum         .        97 

Styptics       ».       ... 

8,37 

Ipecacuanha      .,,        .      211 

Styracol       .         . 

152 

Rhei         .;'      .    -      .      238 

Sublimed  Sulphur  . 

107 

Rubi         .          .          .       199 

Subnitrate  of  Bismuth 

94 

Sarsaparilla  Composi- 

Sudorifics    . 

8 

tus        .         .         .251 

Sugar  of  Lead       . 

64 

Scilla        .         »         .      251 

Sugar  of  Milk 

262 

Compositus    .         93,  251 

Sugars 

.             2 

Senega     ,.,        »,        .      185 

Sulphaminol          .  *.' 

106 

Senna      .         .         .198 

Sulphates     . 

41 

Sulphonal     . 

144 

Tabacum     ....         .      233 

Sulphonethylmethane 

310 

Tables: 

Sulphonmethanum. 

144 

Apothecaries'  Weight         23 

334 


INDEX. 


PAGE 

PAGE 

Tables—  Continued 

Arnica     .         .         »- 

216 

Approximate  Equiv.  . 

24 

Asafatida 

206 

Capacity 

22 

Belladonna  Foliorum 

229 

Equivalents 

23-25 

Benzoini  . 

217 

Length     .         .         . 

21 

Composita   .  . 

218 

Weights    .        '•'.. 

21 

Calumba  . 

172 

Wine  Measure  . 

23 

Cannabis  . 

246 

Tablets 

12 

Capsici 

232 

Taeniacides 

8 

Chloroformi  et  Mor- 

Taka-diastase 

3°9 

phinas   . 

181 

Tamar-Indien 

198 

Cimicifugae 

170 

Tamarind     . 

197 

Cinchona 

207 

Tannalbin    . 

309 

Composita 

207 

Tannic  Acid          . 

117 

Colchici  Seminis 

258 

Glycerite  of 

118 

Digitalis  . 

236 

Ointment  . 

118 

Ferri  Chloridi    . 

75 

Physiological  Actions 

117 

Gelsemii   . 

220 

Preparations 

118 

Gentiana  Composita   . 

224 

Troches     . 

118 

Hydrastis 

171 

Tar     .... 

24? 

Hyoscyami 

231 

Ointment            . 

247 

lodi 

103 

Taraxacum 

21.5 

Ipecacuanhas  et  Opii 

1  80 

Tartar  Emetic        .          91,  276 

Lavandula       Compo- 

Tartaric Acid 

117 

sita 

237 

Tartrates     . 

41 

Lobelia 

217 

Tea  Plant    . 

213 

Nucis  Vomica  . 

223 

Terebenum   .         ^  . 

309 

Opii 

179 

Terpin  Hydrate     . 

309 

Camphorata   . 

179 

Terpinol 

309 

Composita     . 

1  80 

Tetanus 

222 

Deodorati 

179 

Antitoxin  . 

284 

Physostigmatis  . 

I97 

Tetronal      . 

309 

Quassia    . 

192 

Theine 

212 

Rhei 

238 

Theobromine  Sodio-Sali- 

Scilla 

250 

cylate        .         , 

155 

Serpentarias 

24O 

Theophylline 

310 

Stramonii 

231 

Thiersch  Powder  . 

155 

Strophanthi 

225 

Thiophene   . 

106 

Valeriana 

214 

Thoroughwort 

215 

Ammoniata    . 

214 

Thymacetin  . 

310 

Veratri  Viridis  . 

255 

Thymol        ..        . 

238 

Zingiberis. 

245 

Iodide       .         .. 

310 

Tincturae 

9 

Thyroideum  Siccum 

267 

Tincture  of: 

Tinctura: 

Aconite 

168 

Aconiti 

168 

Aloes 

252 

Aloes 

252 

and  Myrrh    . 

252 

et  Myrrhae     . 

252 

Arnica 

216 

INDEX.                                    335 

PAGE 

PAGE 

Tincture  of  —  Continued 

Trochisci    .  .          .          .          9 

Asafetida            .                206 

Acidi  Tannici    .          .       118 

Belladonna  Leaves 

229 

Tropical  Fruit  Laxative.      198 

Benzoin    . 

217 

Tropococain.          .          .      311 

Compound 

218 

Tubercular  Serum          .      285 

Calumba  .          . 

172 

Tully's  Powder     .          .      181 

Cannabis  .          .         * 

246 

Turpene       .         .         .      200 

Capsicum  . 

232 

Tussol          .         V*        .311 

Chloroform  and  Mor 

phine    .     '    . 

181 

Unclassified  Drugs  Alpha- 

Cimicifuga 

170 

betically  Arranged  298-311 

Cinchona  . 

207 

Unguenta     ...          9 

Colchicum  Seed  . 

258 

Unguentum: 

Digitalis  . 

236 

Acidi  Borici       .          .114 

Ferric  Chloride  . 

75 

Acidi  Tannici   .         .      118 

Gelsemium 

220 

Diachylon          .         .        65 

Ginger      .        ". 
Hydrastis  . 
Hyoscyamus 

245 
171 
231 

Hydrargyri  Ammoniati      85 
Hydrargyri  Nitratis  .        86 
Hydrargyri  Oxidi  Flavi       86 

Iodine 

103 

lodi          .         .         .      104 

Ipecac  and  Opium 

1  80 

lodoformi.         .         .105 

Lavender  Compound 

237 

Stramonii.         .         .      230 

Lobelia 

217 

Sulphuris.          .    .      .       107 

Nux  Vomica 

223 

Veratrinas          .          .      256 

Opium      .         ... 

179 

Zinci  Oxidi        .  \     .        70 

Physostigma       .. 

197 

Urethan       :  .      •  ''I      •      J45 

Quassia     .        .  ... 

192 

Urinary,  Acidifiers         .        34 

Rhubarb    .         y. 

238 

Alkalinizers       ..•/.      .        34 

Serpentaria 

240 

Organs      ...        34 

Squill 

250 

Urotropin    .          .         .311 

Stramonium 

231 

Uterine  Depressants      .        35 

Strophanthus     . 

225 

Valerian  . 

214 

Vaccine,        Glycerinated 

Ammoniated  . 

214 

Virus    .         .        269-285 

Veratrum  Viride 

255 

Smallpox  or  Jennerian, 

Tinctures     .  . 

9,  10 

269-285 

Tobacco 

233 

Vaccines      .         .        282,  285 

Toleration    . 

3 

Valerian       .      .  .          .      213 

Toluene 

247 

Vascular  Sedatives         .        27 

Tonics 

8,38 

Vascular  Stimulants      .        27 

Tragacanth  . 

193 

Vaseline       .         .          .163 

Tragacantha  . 

193 

Vegetable  Cathartic  Pills    202 

Trinitrin 

147 

Vegetable  Kingdom       .  i,  165 

Trinitrophenol 

307 

Veratrina     .          .          .      255 

Trional 

310 

Veratrum  Viride   .          .254 

Trituratio  Elaterini 

203 

Veronal        .         .         .      311 

Troches 

9,U 

Vescettes     ."        *•        .        12 

336 


INDEX. 


PAGE 

PAGE 

Vesical  Sedatives  .        •  . 

35 

Wines.         .                    10, 

132 

Vesicants 

.8,  36 

Wolfsbane    . 

165 

Vesicating  Collodion 

189 

Wood  Charcoal         ,     . 

1  08 

Viburnum  Apulus 

206 

Wood  Spirit. 

124 

Viburnum  Prunifolium. 

206 

Wool  Fat      . 

264 

Vinegars      .               9,  I 

o»  "5 

Vinum: 

X-Rays,  the 

290 

Album 

132 

Antimonii 

93 

Yellow,  Jessamine 

219 

Ipecacuanhas     . 

211 

Mercurous  Iodide 

84 

Portense  . 

132 

Wash 

86 

Rubrum  . 

132 

Xericum 

133 

Zinc    .... 

68 

Virus  Vaccinicum. 

269 

Chloride    . 

69 

Ointment  . 

70 

Warburg's  Tincture 

2IO 

Oxide 

70 

Washed  Sulphur   . 
Waters 

107 

9,  10 

Physiological  Actions 
Poisoning. 

68 
68 

Whisky 

131 

Preparations     . 

69 

White  Arsenic 

87 

Sulphate  .  .   ,    .  . 

69 

Whitewash  . 

59 

Treatment  of  Poison- 

White Wine 

132 

ing 

69 

Wild  Cherry 

199 

Zinoi: 

Wine  of: 

Chloridum 

69 

Antimony 

93 

Oxidum    . 

70 

Colchicum  Seed 

258 

Sulphas    .         .         69, 

276 

Ipecac      .        .  . 

211 

Zincum 

68 

Wine  Measure      » 

23 

Zingiber 

245 

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